NPIMap

Organization Active NPI

Vista Adult Care, Inc.

Doing business as Vista Adult Care at Waterfield

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Sparks, NV
National Provider Identifier
1730755158
Registry record updated May 27, 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, INC.
Doing business as
Vista Adult Care at Waterfield
Practice address
3056 Waterfield Dr
Sparks, NV 89434-1627
Phone
(775) 338-2320
Fax
(775) 360-6000
NPI assigned
May 27, 2021
Last updated
May 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Leoncio Macaisa Molino, AO
Title
Manager
Phone
(775) 338-2320

Specialties & licenses 1

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

Addresses

Primary practice location

3056 Waterfield Dr
Sparks, NV 89434-1627

Mailing address

3056 Waterfield Dr
Sparks, NV 89434-1627
Phone (775) 338-2320

Other identifiers 1

IdentifierTypeStateIssuer
10342-AGCMedicaidNV

Other names 1

  • Vista Adult Care at Waterfield Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vista Adult Care Inc4 organizations share this tax ID, including this one

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": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1730755158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 WATERFIELD DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894341627",
            "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 DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894341627",
            "telephone_number": "775-338-2320",
            "fax_number": "775-360-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA ADULT CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "MOLINO",
        "authorized_official_first_name": "LEONCIO",
        "authorized_official_middle_name": "MACAISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "775-338-2320",
        "authorized_official_credential": "AO"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10342-AGC",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Adult Care at Waterfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 27, 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.