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NPI Code Detail

MEDICARE: BONVIVA LLC

MEDICARE: BONVIVA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251V00000XVoluntary or Charitable Agency
2253Z00000XIn Home Supportive Care Agency
3332U00000XHome Delivered Meals
4343800000XSecured Medical Transport (VAN)
5364SH1100XHolistic Clinical Nurse Specialist
6372500000XChore Provider
7372600000XAdult Companion
8101YM0800XMental Health Counselor
9103TE1100XExercise & Sports Psychologist
10163WH0200XHome Health Registered Nurse
11163WN1003XNutrition Support Registered Nurse
12251E00000XHome Health Agency
13251F00000XHome Infusion Agency
14343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1801527015
Entity Type Code : Organization
Provider Name (Legal Business Name) : BONVIVA LLC
Provider Business Mailing Address
First Line : 2331 RIATA PARK CT
Second Line :
City : KATY
State : TX
Zip : 77494-5092
Country : US
Telephone Number : 832-377-1220
Fax Number :
Provider Business Practice Location Address
First Line : 2331 RIATA PARK CT
Second Line :
City : KATY
State : TX
Zip : 77494-5092
Country : US
Telephone Number : 832-377-1220
Fax Number :
Authorized Official
Title or Position : CEO
Name : CHELSEA WILLIS
Credential : RN
Telephone Number : 801-628-3917
Provider Enumeration Date : 06/19/2022
Last Update Date : 08/02/2022

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Directions to “BONVIVA LLC ” Practice Location

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