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Organization
VISTA ADULT CARE LLC
Active
Organization
VISTA ADULT CARE LLC
Active
Parent organization
VISTA ADULT CARE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VISTA ADULT CARE LLC
Authorized official
MR. LEONCIO MACAISA MOLINO (OWNER/MANAGER.)
(775) 338-2320
Entity
Organization
Contact information
Practice address
3056 WATERFIELD DRIVE, SPARKS, NV 89434-1627
(775) 338-2320
(775) 360-6000
Mailing address
1079 RICCO DRIVE, SPARKS, NV 89434-6603
(775) 338-2320
(775) 360-6000
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
5849AGC
NV
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10343-AGC-0
DPBH
NV
Enumeration date
01/23/2015
Last updated
06/04/2021
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