Vista Pacifica Enterprises

LBN: Holly House
Vista Pacifica Enterprises is an health care organization with primary practice located at 773 E Holly St , Rialto CA 92376-4520. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Holly House can be contacted via phone (909) 874-7690, or through Jumonville, Cheryl via phone (951) 682-4833.

Contact Information

Primary practice address
773 E Holly St Rialto CA 92376-4520
Phone: (909) 874-7690
Fax: (909) 874-8689
Website:
Map and Directions
Authorized official contact:
Name: Jumonville, Cheryl
Phone: (951) 682-4833

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X California

Profile Details

NPI number 1801911797
LBN Legal business name Holly House
DBA Doing business as Vista Pacifica Enterprises
Authorized official Jumonville, Cheryl
Entity Organization
Organization subpart 1 No
Enumeration date Mar 20th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801911797 NPPES
California MEDICAID 2400000518

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