MEDICARE: VISTA HEALTH CARE SOLUTION

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	261QR0800X	Recovery Care Clinic/Center
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	279930	OTHER	MA	LICENSE NUMBER

General Provider Information

NPI Number	:	1831898253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISTA HEALTH CARE SOLUTION

Provider Business Mailing Address
First Line	:	9 VISTA AVE
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-1027
Country	:	US
Telephone Number	:	781-521-0302
Fax Number	:

Provider Business Practice Location Address
First Line	:	84 HIGHLAND AVE STE 304
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-2733
Country	:	US
Telephone Number	:	781-521-0302
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ABILA PRIMUS BENAZEA
Credential	:	DNP
Telephone Number	:	781-521-0302

Provider Enumeration Date	:	02/24/2023
Last Update Date	:	10/18/2023

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Directions to “VISTA HEALTH CARE SOLUTION ” Practice Location

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