Healthcare Provider Details

I. General information

NPI: 1245118868
Provider Name (Legal Business Name): MOUNTAIN VIEW SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 FERNDALE APARTMENTS RD
PINEVILLE KY
40977-8578
US

IV. Provider business mailing address

39 FERNDALE APARTMENTS RD
PINEVILLE KY
40977-8578
US

V. Phone/Fax

Practice location:
  • Phone: 606-337-7071
  • 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 State

VIII. Authorized Official

Name: ADAM JAMES MADISON
Title or Position: AGENT
Credential:
Phone: 205-612-0809