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General NPI Number Information
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NPI Number | 1679399208
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Entity Type | Organization
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Legal Business Name | VISTA ROSEVILLE SENIOR LIVING INC.
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 100 STERLING CT
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City | ROSEVILLE
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State | CA
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Zip | 95661-3753
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Country | US
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Telephone | 916-786-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N BARRANCA ST STE 200
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City | WEST COVINA
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State | CA
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Zip | 91791-1651
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PEOPLE & OPERATIONS MANAGER
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Name | CLAUDIA CROWLEY
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Credential |
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Telephone | 951-532-8084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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