Organization
VISTA ASSISTED LIVING
Active
Parent organization
VALLEY VISTA CARE CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
VALLEY VISTA CARE CORPORATION
Authorized official
KASEY WILKS (DIRECTOR OF CORPORATE COMPLIANCE)
(208) 245-4576
Entity
Organization
Contact information
Practice address
820 ELM DR, ST MARIES, ID 83861-2119
(208) 245-4576
(208) 245-2138
Mailing address
243 N 300 E, RUPERT, ID 83350-9491
(208) 436-3332
(208) 436-1289
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M0026110-006
—
ID
Enumeration date
06/25/2010
Last updated
04/09/2025
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