| NPI | 1831898253 |
|---|---|
| Doing Business As | VISTA MAT LLC |
| Entity Type | Organization |
| Authorized Contact | ABILA PRIMUS BENAZEA CEO 781-521-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2023-02-24 |
| Last Update Date | 2023-10-18 |