Provider Demographics
NPI:1952647133
Name:BUENA VISTA HEALTH CARE
Entity Type:Organization
Organization Name:BUENA VISTA HEALTH CARE
Other - Org Name:VISTA POINT REHAB AND CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JUDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BIENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-812-2550
Mailing Address - Street 1:1400 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-2604
Mailing Address - Country:US
Mailing Address - Phone:405-733-1794
Mailing Address - Fax:405-733-7835
Practice Address - Street 1:1400 BUENA VISTA AVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-2604
Practice Address - Country:US
Practice Address - Phone:405-733-1794
Practice Address - Fax:405-733-7835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK375377Medicare Oscar/Certification