Organization
BELLA VITA WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY KNUDSON (MEMBER)
(480) 269-7906
Entity
Organization
Contact information
Practice address
8812 E PALM LN, MESA, AZ 85207-9113
(480) 269-7906
Mailing address
PO BOX 1503, QUEEN CREEK, AZ 85142-1833
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
04/24/2025
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