Provider Demographics
NPI:1912189812
Name:BHC VISTA OPERATIONS LLC
Entity Type:Organization
Organization Name:BHC VISTA OPERATIONS LLC
Other - Org Name:VISTA HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-464-6122
Mailing Address - Street 1:329 NORTH REAL ROAD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301
Mailing Address - Country:US
Mailing Address - Phone:661-395-0803
Mailing Address - Fax:661-327-3147
Practice Address - Street 1:247 E BOBIER DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-3026
Practice Address - Country:US
Practice Address - Phone:760-724-3169
Practice Address - Fax:760-724-3169
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFEHOUSE HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-03
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPPROVAL PENDING314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555723Medicare Oscar/Certification