Healthcare Provider Details

I. General information

NPI: 1407361454
Provider Name (Legal Business Name): NUVISTA LIVING AT JUPITER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2017
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

674 PIONEER RD FL 33458
JUPITER FL
33458-9011
US

IV. Provider business mailing address

674 PIONEER RD
JUPITER FL
33458-9011
US

V. Phone/Fax

Practice location:
  • Phone: 561-532-1800
  • Fax:
Mailing address:
  • Phone: 561-532-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: TRICIA L. THACKER
Title or Position: CEO
Credential:
Phone: 813-558-6600