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NPI Code Detail

MEDICARE: MOUNTAIN VIEW TENANT LLC

MEDICARE: MOUNTAIN VIEW TENANT 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
1314000000XSkilled Nursing FacilityCO

General Provider Information

NPI Number : 1306190244
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNTAIN VIEW TENANT LLC
Provider Business Mailing Address
First Line : 8101 E MISSISSIPPI AVE
Second Line :
City : DENVER
State : CO
Zip : 80247-1104
Country : US
Telephone Number : 303-369-0736
Fax Number :
Provider Business Practice Location Address
First Line : 8101 E MISSISSIPPI AVE
Second Line :
City : DENVER
State : CO
Zip : 80247-1104
Country : US
Telephone Number : 303-369-0736
Fax Number :
Authorized Official
Title or Position : AUTHORIZED REPRESENTATIVE
Name : GERI KRUPP-GORDON
Credential :
Telephone Number : 414-918-5000
Provider Enumeration Date : 10/30/2012
Last Update Date : 01/24/2017

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Directions to “MOUNTAIN VIEW TENANT LLC ” Practice Location

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