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NPI Code Detail

MEDICARE: NORTHVIEW VILLAGE, INC.

MEDICARE: NORTHVIEW VILLAGE, INC.
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 Facility265524MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538108469
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHVIEW VILLAGE, INC.
Provider Business Mailing Address
First Line : 2415 N KINGSHIGHWAY BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63113-1109
Country : US
Telephone Number : 314-361-1300
Fax Number : 314-361-1374
Provider Business Practice Location Address
First Line : 2415 N KINGSHIGHWAY BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63113-1109
Country : US
Telephone Number : 314-361-1300
Fax Number : 314-361-1374
Authorized Official
Title or Position : PRESIDENT
Name : MAKHLOUF SUISSA
Credential :
Telephone Number : 314-361-1300
Provider Enumeration Date : 06/06/2006
Last Update Date : 12/23/2009

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Directions to “NORTHVIEW VILLAGE, INC. ” Practice Location

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