Provider Demographics
NPI:1437651221
Name:VALLE VISTA LLC
Entity Type:Organization
Organization Name:VALLE VISTA LLC
Other - Org Name:NEW VISTA OUTPATIENT RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3482
Mailing Address - Street 1:898 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1407
Mailing Address - Country:US
Mailing Address - Phone:317-887-1348
Mailing Address - Fax:
Practice Address - Street 1:65 AIRPORT PKWY STE 104
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1439
Practice Address - Country:US
Practice Address - Phone:317-883-5330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone