Provider Demographics
NPI:1588284269
Name:VISTA HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:VISTA HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-709-3183
Mailing Address - Street 1:7941 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8000
Mailing Address - Country:US
Mailing Address - Phone:786-709-3183
Mailing Address - Fax:305-266-7854
Practice Address - Street 1:7941 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8000
Practice Address - Country:US
Practice Address - Phone:786-709-3183
Practice Address - Fax:305-266-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty