Organization
BELLARAE HOME CARE AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN GUARA (AGENCY MANAGER)
(970) 361-3399
Entity
Organization
Contact information
Practice address
784 CRYSTAL WAY, FRUITA, CO 81521-3317
(970) 361-3399
(877) 679-2777
Mailing address
784 CRYSTAL WAY, FRUITA, CO 81521-3317
(970) 361-3399
(877) 679-2777
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
04Z835
CO
253Z00000X
In Home Supportive Care Agency
Primary
04V336
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04V336
COLORADO SUBLICENSE FOR IN-HOME SUPPORT SERVICES
CO
01
—
04Z835
COLORADO HOME CARE AGENCY CLASS-B NON-MEDICAL LICENSE
CO
Enumeration date
12/13/2016
Last updated
12/13/2016
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