Healthcare Provider Details

I. General information

NPI: 1659824472
Provider Name (Legal Business Name): MOUNTAIN VIEW HEALTHCARE AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W RUSSELL ST
ELKHORN CITY KY
41522-9032
US

IV. Provider business mailing address

945 W RUSSELL ST PO BOX 650
ELKHORN CITY KY
41522-9032
US

V. Phone/Fax

Practice location:
  • Phone: 606-754-4134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateKY

VIII. Authorized Official

Name: JOSEPH SCHWARTZ
Title or Position: MANAGER
Credential:
Phone: 201-635-1195