Provider Demographics
NPI:1881221661
Name:LA VITA BELLA HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:LA VITA BELLA HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAHNELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-239-9146
Mailing Address - Street 1:8201 GOLF COURSE RD NW
Mailing Address - Street 2:SUITE D3, #221
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120
Mailing Address - Country:US
Mailing Address - Phone:505-239-9146
Mailing Address - Fax:
Practice Address - Street 1:5901 INDIAN SCHOOL RD NE STE 102
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5200
Practice Address - Country:US
Practice Address - Phone:505-814-5386
Practice Address - Fax:505-346-1570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty