Healthcare Provider Details

I. General information

NPI: 1003243577
Provider Name (Legal Business Name): VISTA BEHAVIORAL HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BROCKTON AVE
RIVERSIDE CA
92506-1862
US

IV. Provider business mailing address

4020 ASPEN GROVE DR STE 900
FRANKLIN TN
37067-3134
US

V. Phone/Fax

Practice location:
  • Phone: 951-275-8400
  • Fax: 951-786-0293
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number250000476
License Number StateCA

VIII. Authorized Official

Name: BRIAN P. FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-861-6000