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General NPI Number Information
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NPI Number | 1649510496
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Entity Type | Organization
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Legal Business Name | RIO VISTA AFH
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Dates
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Enumeration Date | 02/14/2013
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 10106 SE FRENCH RD
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City | VANCOUVER
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State | WA
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Zip | 98664-3726
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Country | US
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Telephone | 360-253-6813
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Fax | 360-253-8405
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Provider Business Mailing Address
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Address Line | 10106 SE FRENCH RD
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City | VANCOUVER
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State | WA
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Zip | 98664-3726
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Country | US
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Telephone | 360-253-6813
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Fax | 360-253-8405
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | BELEN NONE ORTIZ
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Credential | ADULT CARE HOME
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Telephone | 360-253-6813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 613900
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License Number State | WA
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