Healthcare Provider Details

I. General information

NPI: 1912189812
Provider Name (Legal Business Name): BHC VISTA OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 E BOBIER DR
VISTA CA
92084-3026
US

IV. Provider business mailing address

329 NORTH REAL ROAD
BAKERSFIELD CA
93301
US

V. Phone/Fax

Practice location:
  • Phone: 760-724-3169
  • Fax: 760-724-3169
Mailing address:
  • Phone: 661-395-0803
  • Fax: 661-327-3147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberAPPROVAL PENDING
License Number StateCA

VIII. Authorized Official

Name: LOU ANDRIOTTI
Title or Position: CEO
Credential:
Phone: 616-464-6122