Healthcare Provider Details
I. General information
NPI: 1841255536
Provider Name (Legal Business Name): PARK VIEW VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1204 W PARK AVE
OLIVIA MN
56277-1487
US
IV. Provider business mailing address
901 WILLMAR AVE SE
WILLMAR MN
56201-4604
US
V. Phone/Fax
- Phone: 320-523-1743
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | MN |
VIII. Authorized Official
Name:
ALANA
ZIEHL
Title or Position: OFFICE MANAGER
Credential:
Phone: 320-214-5603