Vista Recovery Systems, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC0000002819 Issued in TN

Legal business name

VISTA RECOVERY SYSTEMS, INC

Practice address

3114 Browns Mill Rd
Johnson City, TN 37604-1417

Phone

(423) 631-0432

Fax

(423) 631-0284

NPI assigned

Jan 17, 2013

Last updated

Jan 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teddy Leroy Moorehouse, LPC

Title

Secratary

Phone

(423) 631-0432

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1487992939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 BROWNS MILL RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041417",
            "telephone_number": "423-631-0432",
            "fax_number": "423-631-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 BROWNS MILL RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041417",
            "telephone_number": "423-631-0432",
            "fax_number": "423-631-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA RECOVERY SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "MOOREHOUSE",
        "authorized_official_first_name": "TEDDY",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "SECRATARY",
        "authorized_official_telephone_number": "423-631-0432",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TN",
            "license": "LPC0000002819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shane D. Vore, PMHNP-BC

• Community/Behavioral Health Agency in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Community/Behavioral Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.