Organization
VIDA HEALTH WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA BAHENA APRN (OWNER)
(773) 413-7264
Entity
Organization
Contact information
Practice address
5747 W FULLERTON AVE, CHICAGO, IL 60639-2353
(773) 413-7264
Mailing address
5747 W FULLERTON AVE, CHICAGO, IL 60639-2353
(773) 413-7264
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
06/28/2024
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