Fairway Vista Corp.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FAIRWAY VISTA CORP.

Practice address

3508 Tournament Dr
Palmdale, CA 93551-5633

Phone

(661) 878-5085

NPI assigned

May 30, 2024

Organization subpart

No

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

Authorized official

Name

Jaime Landicho

Title

Ceo

Phone

(661) 878-5085

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1912747494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3508 TOURNAMENT DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935515633",
            "telephone_number": "661-878-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3508 TOURNAMENT DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935515633",
            "telephone_number": "661-878-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWAY VISTA CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "LANDICHO",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-878-5085"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Palmdale, CA
• Providers in Palmdale, 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 May 31, 2024; 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.