Organization
NEW VISTA RECOVERY, INC.
Active
Other names
Mountain Vista Farm
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN FONG MBA (DIRECTOR OF MANAGED CARE)
(707) 996-6716
Entity
Organization
Contact information
Practice address
3020 WARM SPRINGS RD, GLEN ELLEN, CA 95442-8730
(707) 996-6716
(707) 996-0609
Mailing address
3020 WARM SPRINGS RD, GLEN ELLEN, CA 95442-8730
(707) 996-6716
(707) 996-0609
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
490025AP
CA
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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