| Bella Vista Resources | |
|
5911 E Nance St Mesa AZ 85215-1485 | |
| (480) 305-3160 | |
| Not Available |
| Full Name | Bella Vista Resources |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5911 E Nance St, Mesa, Arizona |
| Authorized Official Name and Position | Diana Marie Kyrisch (PRESIDENT) |
| Authorized Official Contact | 4803053160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bella Vista Resources Po Box 22243 Mesa AZ 85277-2243 Ph: (480) 305-3160 | Bella Vista Resources 5911 E Nance St Mesa AZ 85215-1485 Ph: (480) 305-3160 |
| NPI Number | 1780979583 |
|---|---|
| Provider Enumeration Date | 06/09/2011 |
| Last Update Date | 06/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780979583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW 12033 (Arizona) | Primary |
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