Provider Demographics
NPI:1528228152
Name:VISTA COVE CARE CENTER AT CORONA, INC.
Entity Type:Organization
Organization Name:VISTA COVE CARE CENTER AT CORONA, INC.
Other - Org Name:VISTA COVE CARE CENTER AT CORONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BONAPARTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-644-4664
Mailing Address - Street 1:2600 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5941
Mailing Address - Country:US
Mailing Address - Phone:951-736-4700
Mailing Address - Fax:951-736-4999
Practice Address - Street 1:2600 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5941
Practice Address - Country:US
Practice Address - Phone:951-736-4700
Practice Address - Fax:951-736-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility