MEDICARE: NEW VISTA HEALTH SERVICES, INC

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
1	314000000X	Skilled Nursing Facility	920000027	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386631885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW VISTA HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	8647 FENWICK ST
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-1957
Country	:	US
Telephone Number	:	818-352-1421
Fax Number	:	818-951-5842

Provider Business Practice Location Address
First Line	:	8647 FENWICK ST
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-1957
Country	:	US
Telephone Number	:	818-352-1421
Fax Number	:	818-951-5842

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JOEL WALDMAN
Credential	:
Telephone Number	:	818-352-1421

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	10/27/2011

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Directions to “NEW VISTA HEALTH SERVICES, INC ” Practice Location

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