AVISTA SENIOR LIVING VITA BELLA, LLC; NPI #1902185994

Contact Information

AVISTA SENIOR LIVING VITA BELLA, LLC

248 N MACDONALD
MESA, AZ 85201-6651

Phone: 480-964-6685
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Health Service	261QH0100X

Indicates primary specialty

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

NPI Number 1902185994

LBN Legal business name AVISTA SENIOR LIVING VITA BELLA, LLC

Authorized official KRISTOPHER WOOLLEY - (MANAGING MEMBER)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/09/2011

Last updated 08/09/2011 - About 15 years ago

Identifiers

Medicaid

AL8507C

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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