National Provider Identifier Database

AVISTA SENIOR LIVING VITA BELLA LLC
Health Service


Contact Information

AVISTA SENIOR LIVING VITA BELLA, LLC
248 N MACDONALD
MESA, AZ85201-6651
Phone: 480-964-6685
Fax:
Website:
Specialty Taxonomy Code
* Health Service 261QH0100X

* Indicates primary specialty

NPI Profile & details for AVISTA SENIOR LIVING VITA BELLA, LLC

NPI Number 1902185994
Legal business name
LBN
AVISTA SENIOR LIVING VITA BELLA, LLC
Authorized official KRISTOPHER WOOLLEY - (MANAGING MEMBER)
Entity Organization
Organization subpart No
Enumeration date 08/09/2011
Last updated 08/09/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: AL8507C

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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