Bevilacqua LLC

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · El Prado, NM

NPI 1508609868 · NPPES record last updated Oct 23, 2024

Key facts

NPI
1508609868
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
BEVILACQUA LLC
Practice address
1518 Paseo del Pueblo Norte Unit 11
El Prado, NM 87529-8004
Phone
(724) 244-4815
NPI assigned
Jun 14, 2024
Organization subpart
No

Authorized official

Name
Leah Bevilacqua
Title
Owner
Phone
(724) 244-4815

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1518 Paseo del Pueblo Norte
Unit 11
El Prado, NM 87529
Phone (724) 244-4815

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

1518 Paseo del Pueblo Norte Unit 11
El Prado, NM 87529-8004

Mailing address

PO Box 11
El Prado, NM 87529-0011

Other providers in El Prado, NM

All providers in El Prado, NM · Mental Health Clinic/Center (Including Community Mental Health Center) in New Mexico

Sources for this page

Verify at the official NPI Registry.