Healthcare Provider Details
I. General information
NPI: 1437155173
Provider Name (Legal Business Name): PARKVIEW HAVEN NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2005
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1203 4TH STREET
DESHLER NE
68340-0667
US
IV. Provider business mailing address
1203 4TH STREET
DESHLER NE
68340-0667
US
V. Phone/Fax
- Phone: 402-365-7237
- Fax: 402-365-7737
- Phone: 402-365-7237
- Fax: 402-365-7737
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
MARY
MILLER
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 402-365-7237