Provider Demographics
NPI:1992706162
Name:MISSION VISTA BEHAVIORAL HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:MISSION VISTA BEHAVIORAL HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT ACCOUNTING
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-679-2157
Mailing Address - Street 1:14747 JONES MALTSBERGER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3713
Mailing Address - Country:US
Mailing Address - Phone:210-497-0004
Mailing Address - Fax:210-572-1447
Practice Address - Street 1:14747 JONES MALTSBERGER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3713
Practice Address - Country:US
Practice Address - Phone:210-497-0004
Practice Address - Fax:210-572-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX454102Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER