VALLEY VISTA CARE CORPORATION (NPI# 1780751966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780751966 |
| Entity Type | Organization |
| Organization Name | VALLEY VISTA CARE CORPORATION |
| Other Organization Name | COUNTRYSIDE ASSISTED LIVING |
| Practice Address |
4433 Beverland Road Mackay ID 83251-0239 |
| Mailing Address |
820 Elm St St Maries ID 83861-2119 |
| Practice Telephone | 2085882600 |
| Practice Fax Number | 2085883104 |
| Mailing Telephone | 2082454576 |
| Mailing Fax Number | 2082452138 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GAIL MILLS (CORPORATE COMPLIANCE MANAGER) |
| Authorized Official Telephone | 2082454576 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Countryside Assisted Living | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194892489 | Valley Vista Care Corporation | Community/Behavioral Health | 127 S 7th St, St Maries, ID 83861-1801 | 2006-11-29 |
| 1881761476 | Valley Vista Care Corporation | Assisted Living Facility | 3668 W. 3700 N., Darlington, ID 83255-0909 | 2006-11-29 |
| 1770599409 | Valley Vista Care Corporation | Skilled Nursing Facility | 820 Elm St, St Maries, ID 83861-2119 | 2006-08-01 |
| 1497761050 | Valley Vista Care Corporation | Skilled Nursing Facility | 220 S Division Ave, Sandpoint, ID 83864-1759 | 2006-08-01 |
| 1194056598 | Valley Vista Care Corporation | Skilled Nursing Facility | 220 S Division Ave, Sandpoint, ID 83864-1759 | 2010-01-25 |
| 1336216621 | Valley Vista Care Corporation | Clinic/Center | 127 S 7th St, St Maries, ID 83861-1801 | 2006-11-29 |
| 1134296437 | Valley Vista Care Corporation | Family Medicine | 820 Elm St, St Maries, ID 83861-2119 | 2006-11-29 |
| Street Address |
4433 BEVERLAND ROAD |
| City | MACKAY |
| State | ID |
| Zip Code | 83251-0239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063918464 | Idaho Psychological Resources LLC | Social Worker | 4433 Beverland Road, Mackay, ID 83251 | 2018-04-04 |
| 1093087033 | Jefferson H Kraczek | Social Worker | 4433 Beverland Road, Mackay, ID 83251-8048 | 2012-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679029805 | Lori Palmer | In Home Supportive Care | 402 Elm Street, Mackay, ID 83251 | 2016-08-28 |
| 1265878995 | Summit View Dental Services Pllc | Clinic/Center | 211 E Custer St, Mackay, ID 83251 | 2013-05-21 |
| 1144512427 | Two Rivers Family and Cosmetic Dentistry, P.a. | Dentist | 304 So Main Street, Mackay, ID 83251 | 2011-05-05 |
| 1871766519 | O-bar Family Dental | Clinic/Center | 304 So Main, Mackay, ID 83251 | 2008-04-02 |
| 1225254238 | Personal Home Care Inc. | Nursing Care | 211 Elm, Mackay, ID 83251 | 2007-04-18 |
| 1760402663 | Lost Rivers Medical Center | Family Medicine | 313 Hwy 93, Mackay, ID 83251 | 2006-07-20 |
| 1174829238 | Two Rivers Dental, Pllc | Dentist | 304 S Main St, Mackay, ID 83251 | 2011-02-07 |
| 1487764551 | South Custer Emergency Medical Technicians Inc | Ambulance | 202 Mccaleb Str, Mackay, ID 83251-0037 | 2006-08-30 |
| 1841359551 | Mountain High Shuttle LLC | Non-emergency Medical Transport (VAN) | 204 White Knob, Mackay, ID 83251-0212 | 2006-12-08 |
| 1770790842 | County of Custer Sch Dist #182 | Local Education Agency (LEA) | 400 E Spruce Street, Mackay, ID 83251-0390 | 2007-05-17 |
| Find all providers in zip 83251 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881761476 | Valley Vista Care Corporation | Assisted Living Facility | 3668 W. 3700 N., Darlington, ID 83255-0909 | 2006-11-29 |
Please comment or provide details below to improve the information on VALLEY VISTA CARE CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.