Healthcare Provider Details

I. General information

NPI: 1982695722
Provider Name (Legal Business Name): VALLEY VIEW SENIOR LIFE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W ASH ST
JUNCTION CITY KS
66441-3332
US

IV. Provider business mailing address

1417 W ASH ST
JUNCTION CITY KS
66441-3332
US

V. Phone/Fax

Practice location:
  • Phone: 785-762-2162
  • Fax: 785-762-5036
Mailing address:
  • Phone: 785-762-2162
  • Fax: 785-762-5036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberN031003
License Number StateKS

VIII. Authorized Official

Name: MR. CHRISTOPHER A. REA
Title or Position: ADMINISTRATOR
Credential:
Phone: 785-762-2162