Healthcare Provider Details

I. General information

NPI: 1497256770
Provider Name (Legal Business Name): NEW VISTA BEHAVIORAL HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 NEWTOWN PIKE BLDG 1
LEXINGTON KY
40511-1277
US

IV. Provider business mailing address

1351 NEWTOWN PIKE BLDG 1
LEXINGTON KY
40511-1277
US

V. Phone/Fax

Practice location:
  • Phone: 859-253-1686
  • Fax: 859-254-2743
Mailing address:
  • Phone: 859-253-1686
  • Fax: 859-254-2743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL BEATRICE
Title or Position: CEO
Credential:
Phone: 859-253-1686