| NPI | 1104442847 |
|---|---|
| Doing Business As | BELLA VIDA HEALTH SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | DIANA MARIE PORTILLO Owner/Provider 575-288-1336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-10-02 |