Organization
VISTA PACIFICA ENTERPRISES INC.
Active
Other names
Vista Pacifica Convalescent
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL B JUMONVILLE (ADMINISTRATOR)
(951) 682-4833
Entity
Organization
Contact information
Practice address
3662 PACIFIC AVE, RIVERSIDE, CA 92509-1948
(951) 682-4833
(951) 682-1503
Mailing address
3662 PACIFIC AVE, RIVERSIDE, CA 92509-1948
(951) 682-4833
(951) 682-1503
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
250000116
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250000116
—
CA
Enumeration date
07/21/2006
Last updated
10/28/2011
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