NPIMap

Organization Active NPI

Lincoln County Hospital District #3

Doing business as Vista Manor

  • Assisted Living Facility
  • Wilbur, WA
National Provider Identifier
1093825200
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
BH1103 Issued in WA
Legal business name
LINCOLN COUNTY HOSPITAL DISTRICT #3
Doing business as
Vista Manor
Practice address
700 SE Brace St
Wilbur, WA 99185-8801
Phone
(509) 647-2211
Fax
(509) 647-2257
NPI assigned
Aug 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Darci D Linstrum
Title
Business Operations Manager
Phone
(509) 725-7101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X BH1103 WA Primary

Addresses

Primary practice location

700 SE Brace St
Wilbur, WA 99185-8801

Mailing address

10 Nichols St
Davenport, WA 99122-9729
Phone (509) 725-7101

Other identifiers 1

IdentifierTypeStateIssuer
645833MedicaidWA

Other names 1

  • Vista Manor Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2315877Vista Manor700 SE Brace St, Wilbur, WA 99185Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Reardan Health Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093825200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NICHOLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7101",
            "fax_number": "509-725-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SE BRACE ST",
            "city": "WILBUR",
            "state": "WA",
            "postal_code": "991858801",
            "telephone_number": "509-647-2211",
            "fax_number": "509-647-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY HOSPITAL DISTRICT #3",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LINSTRUM",
        "authorized_official_first_name": "DARCI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS MANAGER",
        "authorized_official_telephone_number": "509-725-7101",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "BH1103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645833",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilbur, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.