Provider Demographics
NPI:1851069033
Name:BELLA VITA HEALTHCARE, LLC
Entity type:Organization
Organization Name:BELLA VITA HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPICE CARE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-360-6888
Mailing Address - Street 1:3680 GRANT DR STE A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5369
Mailing Address - Country:US
Mailing Address - Phone:775-360-6888
Mailing Address - Fax:775-360-6885
Practice Address - Street 1:3680 GRANT DR STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5369
Practice Address - Country:US
Practice Address - Phone:775-360-6888
Practice Address - Fax:775-360-6885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty