Provider Demographics
NPI:1851285241
Name:ZIA VISTA HOME HEALTH LLC
Entity type:Organization
Organization Name:ZIA VISTA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBINO
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-269-2052
Mailing Address - Street 1:4762 PUNTA DE VIS
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-4609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6441 CERROS GRANDES DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-1822
Practice Address - Country:US
Practice Address - Phone:915-269-2052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health