Vista Care Nevada, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

VISTA CARE NEVADA, LLC

Practice address

708 Erie Ave
Sheboygan, WI 53081-4060

Phone

(920) 694-1102

Fax

(920) 694-4685

NPI assigned

Mar 10, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Alan Frey

Title

President

Phone

(920) 694-1102

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1552176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1760940670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814060",
            "telephone_number": "920-694-1102",
            "fax_number": "920-694-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814060",
            "telephone_number": "920-694-1102",
            "fax_number": "920-694-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA CARE NEVADA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-10",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-694-1102",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vista Care Colorado, LLC
• Vista Care Illinois LLC
• Vista Care South Dakota, LLC
• Vista Care Utah, LLC
• Vista Care Wisconsin Inc.
• Vituity-Wisconsin Em SC
• Vidhyalakshmy Vivek, MD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.