Provider Demographics
NPI:1407361454
Name:NUVISTA LIVING AT JUPITER, LLC
Entity type:Organization
Organization Name:NUVISTA LIVING AT JUPITER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-558-6600
Mailing Address - Street 1:674 PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-9011
Mailing Address - Country:US
Mailing Address - Phone:561-532-1800
Mailing Address - Fax:
Practice Address - Street 1:674 PIONEER RD FL 33458
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-9011
Practice Address - Country:US
Practice Address - Phone:561-532-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-12
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility