MEDICARE: PLANET VIEW 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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1699393728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANET VIEW INC.

Provider Business Mailing Address
First Line	:	18931 E BRUNSWICK PL
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-2321
Country	:	US
Telephone Number	:	505-231-5585
Fax Number	:	303-284-8661

Provider Business Practice Location Address
First Line	:	6994 COUNTY ROAD 39
Second Line	:
City	:	FORT LUPTON
State	:	CO
Zip	:	80621-8528
Country	:	US
Telephone Number	:	505-231-5585
Fax Number	:	303-284-8661

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHUKWUMA E EMEH
Credential	:
Telephone Number	:	505-231-5585

Provider Enumeration Date	:	07/06/2020
Last Update Date	:	07/06/2020

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