Organization
BELLA VISTA RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA MARIE KYRISCH LCSW (PRESIDENT)
(480) 305-3160
Entity
Organization
Contact information
Practice address
5911 E NANCE ST, MESA, AZ 85215-1485
(480) 305-3160
Mailing address
PO BOX 22243, MESA, AZ 85277-2243
(480) 305-3160
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 12033
AZ
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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