Organization Active NPI

Vista Adult Care LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Sparks, NV
National Provider Identifier
1285024679
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
VISTA ADULT CARE LLC
Practice address
3056 Waterfield Drive
Sparks, NV 89434-1627
Phone
(775) 338-2320
Fax
(775) 360-6000
NPI assigned
Jan 23, 2015
Organization subpart
Yes
Parent organization
VISTA ADULT CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Authorized official

Name
Mr. Leoncio Macaisa Molino
Title
Owner/Manager.
Phone
(775) 338-2320

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 5849AGC NV
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

3056 Waterfield Drive
Sparks, NV 89434-1627

Mailing address

1079 Ricco Drive
Sparks, NV 89434-6603
Phone (775) 338-2320

Other identifiers 1

IdentifierTypeStateIssuer
10343-AGC-0OtherNVDPBH

National Provider Directory

National Provider Directory
Tax ID family
Vista Adult Care4 organizations share this tax ID, including this one
Part of
Vista Adult Care

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1285024679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 RICCO DRIVE",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894346603",
            "telephone_number": "775-338-2320",
            "fax_number": "775-360-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 WATERFIELD DRIVE",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894341627",
            "telephone_number": "775-338-2320",
            "fax_number": "775-360-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA ADULT CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VISTA ADULT CARE LLC",
        "enumeration_date": "2015-01-23",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "MOLINO",
        "authorized_official_first_name": "LEONCIO",
        "authorized_official_middle_name": "MACAISA",
        "authorized_official_title_or_position": "OWNER/MANAGER.",
        "authorized_official_telephone_number": "775-338-2320",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NV",
            "license": "5849AGC",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPBH",
            "identifier": "10343-AGC-0",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.