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NPI 1700025863

NPI 1700025863 : VISTA COVE CARE CENTER AT RIALTO, INC. : RIALTO, CA

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General NPI Number Information
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    NPI Number           |    1700025863
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    Entity Type          |    Organization 
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    Legal Business Name  |    VISTA COVE CARE CENTER AT RIALTO, INC. 
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Dates
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    Enumeration Date     |    02/13/2009
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    Last Update Date     |    11/08/2013
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Provider Practice Location Address
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    Address Line         |    1471 S RIVERSIDE AVE 
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    City                 |    RIALTO
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    State                |    CA
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    Zip                  |    92376-7703
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    Country              |    US
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    Telephone            |    909-877-1361
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    Fax                  |    909-877-8912
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Provider Business Mailing Address
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    Address Line         |    1471 S RIVERSIDE AVE 
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    City                 |    RIALTO
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    State                |    CA
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    Zip                  |    92376-7703
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    Country              |    US
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    Telephone            |    909-877-1361
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    Fax                  |    909-877-8912
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Authorized Official
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    Title or Position    |    TREASURER
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    Name                 |     BONAPARTE  LIU 
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    Credential           |    
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    Telephone            |    949-205-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    314000000X
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    Taxonomy Name        |    Skilled Nursing Facility
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    License Number       |    
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    License Number State |    CA
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