OrganizationActive
Vista Maria
NPI 1477639458 · Emotionally Disturbed Childrens' Residential Treatment Facility · Dearborn Heights, MI
Provider details
- NPI number
- 1477639458
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Earl Goddin, Chief Financial Officer(313) 271-3050
- License
- 43 01 052026 (MI)
Specialties & taxonomies
- Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense 43 01 070436 (MI)
Residential Treatment Facilities
Residential Treatment Facilities
Residential Treatment Facilities
Residential Treatment Facilities
Practice location
20651 W Warren Ave
Dearborn Heights, MI 48127-2622
Phone: (313) 271-3050
Fax: (313) 336-3460
Approximate (ZIP-level) locationGet directions
Mailing address
20651 W Warren St
Dearborn Heights, MI 48127-2622
Registry dates
- Enumerated
- 2006-10-31
- Last updated
- 2008-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.