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General NPI Number Information
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NPI Number | 1083586143
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Entity Type | Organization
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Legal Business Name | VISTACARE LLC
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 11/02/2025
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Provider Practice Location Address
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Address Line | 11122 VISTA DEL VALLE DR
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9191
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Country | US
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Telephone | 310-925-8857
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Fax | 323-544-6446
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Provider Business Mailing Address
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Address Line | 11122 VISTA DEL VALLE DR
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9191
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Country | US
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Telephone | 310-925-8857
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Fax | 323-544-6446
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Authorized Official
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Title or Position | LICENSEE/ADMINISTRATOR
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Name | SHEILA PATRICE BAGSBY
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Credential |
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Telephone | 310-925-8857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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