Provider Demographics
NPI:1275187395
Name:VISTA THERAPY CENTER INC
Entity Type:Organization
Organization Name:VISTA THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:I
Authorized Official - Last Name:BATUUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-333-2700
Mailing Address - Street 1:2910 PILLSBURY AVE S
Mailing Address - Street 2:STE 342
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408
Mailing Address - Country:US
Mailing Address - Phone:844-333-2700
Mailing Address - Fax:651-322-2335
Practice Address - Street 1:2910 PILLSBURY AVE S
Practice Address - Street 2:STE 342
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408
Practice Address - Country:US
Practice Address - Phone:844-333-2700
Practice Address - Fax:651-322-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health