VISTA MARIA NPI 1477639458

NPI Information

  • NPI: 1477639458
  • Provider Name: VISTA MARIA
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Address: 20651 W WARREN AVE
    DEARBORN HEIGHTS, MI
    ZIP 48127
  • Phone: (313) 271-3050

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NPI Details

VISTA MARIA is a residential treatment facility emotionally disturbed children in Dearborn Heights, MI. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. VISTA MARIA NPI is 1477639458. The provider is registered as an organization entity type.

The provider's business location address is:

20651 W WARREN AVE
DEARBORN HEIGHTS, MI
ZIP 48127-622
Phone: (313) 271-3050
Fax: (313) 336-3460

The provider's authorized official is Earl Goddin .
The authorized official title is Chief Financial Officer and has the following contact phone number (313) 271-3050.

The enumeration date for this NPI number is 10/31/2006 and was last updated on 4/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed Children43 01 036786MICHIGANNo
2322D00000XResidential Treatment Facility, Emotionally Disturbed Children43 01 052026MICHIGANNo
3322D00000XResidential Treatment Facility, Emotionally Disturbed Children43 01 032319MICHIGANNo
4322D00000XResidential Treatment Facility, Emotionally Disturbed Children43 01 070436MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14646898MEDICAIDMICHIGAN
24512114MEDICAIDMICHIGAN
34652830MEDICAIDMICHIGAN
43241311MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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