Provider Demographics
NPI:1720511371
Name:VISTA VERDE HOME HEALTH
Entity Type:Organization
Organization Name:VISTA VERDE HOME HEALTH
Other - Org Name:VISTA VERDE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIEU-QUI
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-509-1257
Mailing Address - Street 1:1400 COLEMAN AVE
Mailing Address - Street 2:SUITE F15
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4309
Mailing Address - Country:US
Mailing Address - Phone:408-509-1257
Mailing Address - Fax:
Practice Address - Street 1:1400 COLEMAN AVE
Practice Address - Street 2:SUITE F15
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4309
Practice Address - Country:US
Practice Address - Phone:408-509-1257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care