Vista South Assisted Living

LBN: Vista South Assisting Living
Vista South Assisted Living is an health care organization with primary practice located at 1010 E Southern Ave Bldg 2 , Phoenix AZ 85040-5108. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Vista South Assisting Living can be contacted via phone (602) 435-3808, or through Thomas, Kenneth Ray via phone (602) 435-3808.

Contact Information

Primary practice address
1010 E Southern Ave Bldg 2 Phoenix AZ 85040-5108
Phone: (602) 435-3808
Fax: (602) 276-1854
Website:
Map and Directions
Authorized official contact:
Name: Thomas, Kenneth Ray
Phone: (602) 435-3808

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X ALH5881 Arizona

Profile Details

NPI number 1194866277
LBN Legal business name Vista South Assisting Living
DBA Doing business as Vista South Assisted Living
Authorized official Thomas, Kenneth Ray
Entity Organization
Organization subpart 1 No
Enumeration date Feb 9th, 2007
Last updated Sep 6th, 2023 - about 2 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 1194866277 NPPES
Arizona MEDICAID 174413

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