Healthcare Provider Details

I. General information

NPI: 1831199314
Provider Name (Legal Business Name): AMERICAN LUTHERAN CHURCH VALLEY VIEW HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 PERRY LN
GLASGOW MT
59230-1532
US

IV. Provider business mailing address

1225 PERRY LN
GLASGOW MT
59230-1532
US

V. Phone/Fax

Practice location:
  • Phone: 406-228-2461
  • Fax: 406-228-4831
Mailing address:
  • Phone: 406-228-2461
  • Fax: 406-228-4831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9921
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number9958
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number9958
License Number StateMT

VIII. Authorized Official

Name: FRANK W THOMPSON
Title or Position: ADMINISTRATOR
Credential: NAB
Phone: 406-228-2461