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General NPI Number Information
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NPI Number | 1710212972
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Entity Type | Organization
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Legal Business Name | VISTA OAKS SCC, LLC
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 1604 LOHMANS CROSSING RD
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City | AUSTIN
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State | TX
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Zip | 78734-5198
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Country | US
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Telephone | 512-261-6653
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Fax | 512-261-2699
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Provider Business Mailing Address
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Address Line | 2828 N HARWOOD ST STE 1100
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City | DALLAS
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State | TX
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Zip | 75201-1512
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Country | US
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Telephone | 214-252-7600
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Fax | 214-252-7599
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARK S MCKENZIE
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Credential |
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Telephone | 214-252-7600
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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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