Provider Demographics
NPI:1083019822
Name:BELLA VISTA BEHAVIOR SERVICES, LLC
Entity Type:Organization
Organization Name:BELLA VISTA BEHAVIOR SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSIKA
Authorized Official - Middle Name:N
Authorized Official - Last Name:FEIL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:559-372-8175
Mailing Address - Street 1:PO BOX 25042
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5042
Mailing Address - Country:US
Mailing Address - Phone:559-892-4531
Mailing Address - Fax:559-892-4550
Practice Address - Street 1:2316 W WHITENDALE AVE
Practice Address - Street 2:SUITE B, #4
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6131
Practice Address - Country:US
Practice Address - Phone:559-372-8175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty