Vista Behavioral LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

VISTA BEHAVIORAL LLC

Practice address

18022 Lake Encino Dr
Encino, CA 91316-4428

Phone

(973) 277-5359

NPI assigned

Jan 20, 2021

Organization subpart

No

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

Authorized official

Name

Bryan Matthew Disimone

Title

Account Manager

Phone

(973) 277-5359

Specialties & licenses 1

Addresses

Other names 1

• Vista Behavioral Doing business as

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611100800000",
    "number": "1952991374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18022 LAKE ENCINO DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164428",
            "telephone_number": "973-277-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18022 LAKE ENCINO DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164428",
            "telephone_number": "973-277-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA BEHAVIORAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A",
        "authorized_official_last_name": "DISIMONE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "973-277-5359"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Behavioral",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Encino, CA
• Providers in Encino, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.