VISTA SOUTH ASSISTING LIVING (NPI# 1194866277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194866277 |
Entity Type | Organization |
Organization Name | VISTA SOUTH ASSISTING LIVING |
Other Organization Name | VISTA SOUTH ASSISTED LIVING |
Practice Address |
1010 E Southern Ave Bldg 2 Phoenix AZ 85040-5108 |
Practice Telephone | 6024353808 |
Practice Fax Number | 6022761854 |
Mailing Telephone | 6024353808 |
Mailing Fax Number | 6022761854 |
Enumeration Date | 2007-02-09 |
Last Update Date | 2020-08-22 |
Authorized Official Name | KENNETH RAY THOMAS (OWNER) |
Authorized Official Telephone | 6024353808 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | ALH5881 | AZ | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 174413 | 05 |
Other Name | Type Code |
---|---|
Vista South Assisted Living | Other Name - Individual/Organization |
Street Address |
1010 E SOUTHERN AVE BLDG 2 |
City | PHOENIX |
State | AZ |
Zip Code | 85040-5108 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104459072 | Xyz Mobility LLC | Durable Medical Equipment & Medical Supplies | 4014 East Broadway Rd, Suite 405, Phoenix, AZ 85040 | 2020-02-19 |
1184162588 | Moses Assisted Living LLC | Community Based Residential Treatment Facility, Mental Illness | 827 E Chipman Rd, Phoenix, AZ 85040 | 2017-02-06 |
1083164149 | K & C Ventures LLC | Day Training, Developmentally Disabled Services | 4013 E Broadway Road, Phoenix, AZ 85040 | 2016-10-12 |
1952767956 | Otto Bock Orthopedic Services LLC | Prosthetic/Orthotic Supplier | 4022 E Broadway Rd, Suite 119, Phoenix, AZ 85040 | 2016-01-06 |
1679947238 | Garcia's Assisted Living Home LLC | Custodial Care Facility | 2742 E Pueblo Avenue, Phoenix, AZ 85040 | 2015-11-19 |
1578956280 | Ashley Elizabeth Church | Physical Therapist | 5750 S. 32nd St, Phoenix, AZ 85040 | 2015-03-05 |
1720480940 | Above and Beyond Care Providers | Exclusive Provider Organization | 2136 E. Bowker St, Phoenix, AZ 85040 | 2014-09-18 |
1275708505 | Jennifer Louise Koslo | Nutritionist | 5633 South 42nd Street, Phoenix, AZ 85040 | 2008-04-28 |
1639200017 | Kevin Wayne Jones | Specialist/Technologist | 5621 S. 24th Street, Jones Concrete Construction LLC, Phoenix, AZ 85040 | 2007-03-08 |
1861529109 | Jayesh C Patel | Dentist | 522 East Southern Ave, Phoenix, AZ 85040 | 2007-02-27 |
Find all providers in zip 85040 |
Taxonomy Code | 310400000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942800966 | Yibu Liu | Assisted Living Facility | 3569 E Utopia Rd, Phoenix, AZ 85050-3967 | 2020-10-28 |
1609474030 | Fisher Family Home LLC | Assisted Living Facility | 2927 W Redfield Rd, Phoenix, AZ 85053-7712 | 2020-10-16 |
1235736687 | Ana's Assisted Living Home, LLC | Assisted Living Facility | 13238 N 35th St, Phoenix, AZ 85032-6110 | 2020-10-07 |
1881201598 | Latins Home LLC | Assisted Living Facility | 10601 S 42nd St, Phoenix, AZ 85044-1301 | 2020-09-26 |
1659987998 | Mehry Lyn Moses | Assisted Living Facility | 1816 E Whitton Ave, Phoenix, AZ 85016-6416 | 2020-09-22 |
1417562406 | Briceida Rocha | Assisted Living Facility | 1345 W Atlanta Ave, Phoenix, AZ 85041-3929 | 2020-09-15 |
1073127213 | Marlyn Ll Joaquin | Assisted Living Facility | 1349 W Rosemonte Dr, Phoenix, AZ 85027-5444 | 2020-09-04 |
1720602832 | Casa De Vida Living LLC | Assisted Living Facility | 7036 W Parkway Dr, Phoenix, AZ 85043-6921 | 2020-06-04 |
1689295297 | Raj International LLC | Assisted Living Facility | 4312 E Redwood Ln, Phoenix, AZ 85048-7028 | 2020-05-05 |
1285261891 | Sterling Residences, LLC | Assisted Living Facility | 2301 E Lone Cactus Dr, Phoenix, AZ 85024-5507 | 2020-03-24 |
Find all providers in PHOENIX |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.