Buena Vista Al, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BUENA VISTA AL, LLC

Practice address

1393 S Buena Vista St
Hemet, CA 92543-7660

Phone

(951) 658-5160

NPI assigned

Jun 19, 2020

Organization subpart

No

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

Authorized official

Name

Roddy Radnia

Title

Manager

Phone

(310) 435-0797

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Buena Vista Assisted Living Doing business as

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1568088193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8306 WILSHIRE BLVD # 135",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112304",
            "telephone_number": "310-435-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1393 S BUENA VISTA ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437660",
            "telephone_number": "951-658-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUENA VISTA AL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "RADNIA",
        "authorized_official_first_name": "RODDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-435-0797"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DEPARTMENT OF SOCIAL SERVICES",
            "identifier": "331880902",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buena Vista Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nichole K Bryan, M.S.
• Alisha Bryant
• Preston Bryant
• Jesus Amaya Bucardo, M.D.
• Cheryl Ann Buckner
• Buena Vista Assisted Living LLC
• Thach Thao T Bui, PHARM D
• Building Blocks Social Skills Development & Learning Inc
• Teresa Marie Bullock, RRW
• Elaine Renee Burgos la Luz, RN

• Assisted Living Facility in Hemet, CA
• Providers in Hemet, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.