Provider Demographics
NPI:1154669794
Name:NEW VISTA NURSING OPERATOR, LLC
Entity Type:Organization
Organization Name:NEW VISTA NURSING OPERATOR, LLC
Other - Org Name:NEW VISTA NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP, REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CADABES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-273-8900
Mailing Address - Street 1:4250 PENNSYLVANIA AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3369
Mailing Address - Country:US
Mailing Address - Phone:818-273-8900
Mailing Address - Fax:818-273-8910
Practice Address - Street 1:8647 FENWICK ST
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-1957
Practice Address - Country:US
Practice Address - Phone:818-352-1421
Practice Address - Fax:818-951-5842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA056031Medicare Oscar/Certification