Provider Demographics
NPI:1407940448
Name:LA VISTA INC
Entity Type:Organization
Organization Name:LA VISTA INC
Other - Org Name:LA VISTA RECOVERY & WHOLENESS CENTER FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-683-6596
Mailing Address - Street 1:5870 ARLINGTON AVE.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2037
Mailing Address - Country:US
Mailing Address - Phone:951-683-6596
Mailing Address - Fax:951-683-4239
Practice Address - Street 1:294 MIDWAY
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583
Practice Address - Country:US
Practice Address - Phone:951-925-8450
Practice Address - Fax:951-658-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility