Provider Demographics
NPI:1023535846
Name:BELLA VITA ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:BELLA VITA ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LINDA
Authorized Official - Last Name:BUONO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:401-486-0882
Mailing Address - Street 1:22 WAMPANOAG TRL
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-3734
Mailing Address - Country:US
Mailing Address - Phone:401-575-3645
Mailing Address - Fax:401-437-0338
Practice Address - Street 1:22 WAMPANOAG TRL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-3734
Practice Address - Country:US
Practice Address - Phone:401-575-3645
Practice Address - Fax:401-437-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIADC00046261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care