| Bella Vida Health Services Llc | |
|
330 N Campo St Las Cruces NM 88001-3433 | |
| (575) 288-1336 | |
| (575) 222-4453 |
| Full Name | Bella Vida Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 330 N Campo St, 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 330 N Campo St Las Cruces NM 88001-3433 Ph: (575) 288-1336 |
| NPI Number | 1104442847 |
|---|---|
| Provider Enumeration Date | 06/18/2020 |
| Last Update Date | 10/02/2020 |
| 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)) | 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: 2467 S Telshor Blvd, Las Cruces, NM 88011 Phone: 575-647-8366 Fax: 575-647-8381 | |
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 | |
Rhsnm Physician Group 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: Medicare Enrolled 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 |