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NPI 1003243577

NPI 1003243577 : VISTA BEHAVIORAL HOSPITAL LLC : RIVERSIDE, CA

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General NPI Number Information
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    NPI Number           |    1003243577
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    Entity Type          |    Organization 
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    Legal Business Name  |    VISTA BEHAVIORAL HOSPITAL LLC 
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Dates
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    Enumeration Date     |    09/30/2013
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    Last Update Date     |    01/05/2026
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Provider Practice Location Address
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    Address Line         |    5900 BROCKTON AVE 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92506-1862
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    Country              |    US
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    Telephone            |    951-275-8400
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    Fax                  |    951-786-0293
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Provider Business Mailing Address
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    Address Line         |    4020 ASPEN GROVE DR STE 900 
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    City                 |    FRANKLIN
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    State                |    TN
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    Zip                  |    37067-3134
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    Country              |    US
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    Telephone            |    615-861-6000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VP & SECRETARY
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    Name                 |     BRIAN P. FARLEY 
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    Credential           |    
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    Telephone            |    615-861-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    283Q00000X
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    Taxonomy Name        |    Psychiatric Hospital
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    License Number       |    250000476
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    License Number State |    CA
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