Provider Demographics
NPI:1134339682
Name:VISTA HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:VISTA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRUZZESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-420-4411
Mailing Address - Street 1:PO BOX 1537
Mailing Address - Street 2:
Mailing Address - City:MARSTONS MILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02648-5537
Mailing Address - Country:US
Mailing Address - Phone:508-420-4411
Mailing Address - Fax:
Practice Address - Street 1:161 LOVELLS LN
Practice Address - Street 2:
Practice Address - City:MARSTONS MILLS
Practice Address - State:MA
Practice Address - Zip Code:02648-5700
Practice Address - Country:US
Practice Address - Phone:508-420-4411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health