| Bella Vida Health Services Llc | |
| 705 N Alameda Blvd Las Cruces NM 88005-2128 | |
| (575) 288-1336 | |
| (575) 222-4453 | 
| Full Name | Bella Vida Health Services Llc | 
|---|---|
| Speciality | Nurse Practitioner | 
| Location | 705 N Alameda Blvd, Las Cruces, New Mexico | 
| Authorized Official Name and Position | Diana Marie Portillo (OWNER/PROVIDER) | 
| Authorized Official Contact | 5752881336 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Bella Vida Health Services Llc Po Box 1731 Las Cruces NM 88004-1731 Ph: (575) 288-1336 | Bella Vida Health Services Llc 705 N Alameda Blvd Las Cruces NM 88005-2128 Ph: (575) 288-1336 | 
| NPI Number | 1104442847 | 
|---|---|
| Provider Enumeration Date | 06/18/2020 | 
| Last Update Date | 02/24/2025 | 
| Medicare PECOS PAC ID | 2264852334 | 
|---|---|
| Medicare Enrollment ID | O20201013000188 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1104442847 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary | 
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary | 
| Provider Name | Diana Marie Portillo | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1194049841 PECOS PAC ID: 3274666235 Enrollment ID: I20100728000854 | 
| Southwest Center On Aging Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1106 Centre Ct, Las Cruces, NM 88011 Phone: 575-532-5455 Fax: 575-532-5641 | |
| Memorial Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2450 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-521-5385 | |
| Harry Bass, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2425 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-522-0330 Fax: 575-522-8620 | |
| Memorial Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2450 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-521-5385 | |
| Rehabilitation Hospital Of Southern New Mexico Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4441 E Lohman Ave, Las Cruces, NM 88011 Phone: 575-521-6400 | |
| Smart Care, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2801 Missouri Ave Ste 12, Las Cruces, NM 88011 Phone: 575-522-6900 Fax: 575-522-8891 | |
| App Of New Mexico Hm Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4311 E Lohman Ave, Las Cruces, NM 88011 Phone: 575-556-7600 Fax: 629-216-0568 |