Provider Demographics
NPI:1164780268
Name:VISTA CENTER
Entity Type:Organization
Organization Name:VISTA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-238-2970
Mailing Address - Street 1:249 PEER AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-4135
Mailing Address - Country:US
Mailing Address - Phone:810-766-7085
Mailing Address - Fax:810-766-7274
Practice Address - Street 1:249 PEER AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-4135
Practice Address - Country:US
Practice Address - Phone:810-766-7085
Practice Address - Fax:810-766-7274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health