MEDICARE: PARK VIEW CARING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	10439	MT

General Provider Information

NPI Number	:	1073678512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARK VIEW CARING LLC

Provider Business Mailing Address
First Line	:	106 S STREVELL AVE
Second Line	:
City	:	MILES CITY
State	:	MT
Zip	:	59301-3746
Country	:	US
Telephone Number	:	406-234-4104
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 S STREVELL AVE
Second Line	:
City	:	MILES CITY
State	:	MT
Zip	:	59301-3746
Country	:	US
Telephone Number	:	406-234-4104
Fax Number	:

Authorized Official
Title or Position	:	BILLING AGENT
Name	:	DEE ANN KRUGER
Credential	:	RN
Telephone Number	:	406-234-4104

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	09/11/2008

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