Organization
MOUNT VISTA HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB TAUB (AUTHORIZED REP)
(718) 838-1500
Entity
Organization
Contact information
Practice address
202 TIMS AVE, HARRISON, AR 72601-2229
(870) 741-7667
Mailing address
362 E KENNEDY BLVD, LAKEWOOD, NJ 08701-1434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
03/03/2022
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