Provider Demographics
NPI:1205986353
Name:NEW VISTAS
Entity type:Organization
Organization Name:NEW VISTAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:I
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-471-1001
Mailing Address - Street 1:1205 PARKWAY DR STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-6201
Mailing Address - Country:US
Mailing Address - Phone:505-471-1001
Mailing Address - Fax:505-424-4778
Practice Address - Street 1:1205 PARKWAY DR STE A
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-6201
Practice Address - Country:US
Practice Address - Phone:505-471-1001
Practice Address - Fax:505-424-4778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM223OtherNM DEPT OF HEALTH ID
NM000E7214Medicaid
NM000D0735Medicaid