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VISTA MARIA
NPI 1477639458
Residential Treatment Facility, Emotionally Disturbed Children in Dearborn Heights, MI

Active since October 31, 2006CLIA 23D2028349 · Waiver
20651 W WARREN AVE, DEARBORN HEIGHTS, MI 48127(313) 271-3050(313) 336-3460 Get Directions Write a Review

NPPES record last updated: April 7, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Vista Maria NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VISTA MARIA (NPI 1477639458) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Dearborn Heights, Michigan and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Earl Goddin, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1477639458
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameVISTA MARIA
Location Address20651 W WARREN AVEDearborn Heights, MI 48127-2622
Mailing Address20651 W Warren StDearborn Heights, MI 48127-2622 · (313) 271-3050 · Fax (313) 336-3460
Phone(313) 271-3050
Fax(313) 336-3460
Organization SubpartNo
Authorized OfficialEarl GoddinChief Financial Officer · (313) 271-3050
Enumeration DateOctober 31, 2006
Last NPPES UpdateApril 7, 2008
✔ NPI 1477639458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
Licenses✔ Licensed in MI · 43 01 070436✔ Licensed in MI · 43 01 036786✔ Licensed in MI · 43 01 052026✔ Licensed in MI · 43 01 032319
Definition
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.
20651 W WARREN AVE, Dearborn Heights, MI 48127
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Other Identifiers 4

Medicaid4646898MI
Medicaid4512114MI
Medicaid4652830MI
Medicaid3241311MI

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2028349

Vista Maria · Dearborn Heights, MI
Active · expires Aug 14, 2027
CLIA Number23D2028349
Laboratory TypeTreatment Facility Behav
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorAlice M. Malinowski
Laboratory Phone(313) 271-3050
Laboratory LocationVista Maria20651 W Warren Avenue, Dearborn Heights, MI 48127
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vista Maria's NPI number?

The NPI number for Vista Maria is 1477639458. It was assigned to this organization in the NPPES registry on October 31, 2006.

Where is Vista Maria located?

Vista Maria is located at 20651 W Warren Ave, Dearborn Heights, MI 48127. The listed phone number is (313) 271-3050.

What is Vista Maria's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Does Vista Maria hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2028349) is associated with this NPI, valid through August 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vista Maria was last updated on April 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.