Provider Demographics
NPI:1336884030
Name:SUNNY VISTA ASSISTED LIVING FACILITY LLC
Entity Type:Organization
Organization Name:SUNNY VISTA ASSISTED LIVING FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO GALVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-675-7036
Mailing Address - Street 1:8112 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-3112
Mailing Address - Country:US
Mailing Address - Phone:813-613-0869
Mailing Address - Fax:
Practice Address - Street 1:8112 N 9TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-3112
Practice Address - Country:US
Practice Address - Phone:813-613-0869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility