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General NPI Number Information
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NPI Number | 1346597671
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Entity Type | Organization
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Legal Business Name | BELLA VISTA THERAPY GROUP, INC.
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 13965 HUDSON ST
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City | THORNTON
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State | CO
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Zip | 80602-7834
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Country | US
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Telephone | 303-808-8985
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Fax |
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Provider Business Mailing Address
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Address Line | 13965 HUDSON ST
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City | THORNTON
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State | CO
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Zip | 80602-7834
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Country | US
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Telephone | 303-808-8985
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | MRS. OLIVIA O EPPE
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Credential | M.A., CCC-SLP
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Telephone | 303-808-8985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 12018641
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License Number State | CO
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