Lavista Operating Company LLC
Custodial Care Facility, Adult Care Home in Tucker, GA. Organization (NPI-2).
NPI number1972053296
StatusActive
Last updated in NPPESOct 11, 2016
Details
- NPI
- 1972053296
- Entity type
- Organization (NPI-2)
- Legal business name
- Lavista Operating Company LLC
- Organization subpart
- No
- Enumeration date
- Oct 11, 2016
- Last updated
- Oct 11, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – | Yes |
Other names
- Bentley Square (Doing Business As)
Practice location
3884 Lavista RdTucker, GA 30084-5199
Phone 770-938-7260
Mailing address
5300 W Sam Houston Pkwy NSuite 100
Houston, TX 77041-5161
Phone 832-467-6000
Authorized official
Kelle C Santoro
Sr Director Ar
8324675728
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