Bella Vita Wellness LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BELLA VITA WELLNESS LLC

Practice address

8812 E Palm LN
Mesa, AZ 85207-9113

Phone

(480) 269-7906

NPI assigned

Jan 14, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cody Knudson

Title

Member

Phone

(480) 269-7906

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1245041813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1503",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8812 E PALM LN",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852079113",
            "telephone_number": "480-269-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA VITA WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "KNUDSON",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "480-269-7906"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Mesa, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.