Healthcare Provider Details

I. General information

NPI: 1952481491
Provider Name (Legal Business Name): PARKVIEW HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 2ND ST
DODGE NE
68633-3555
US

IV. Provider business mailing address

930 2ND ST
DODGE NE
68633-3555
US

V. Phone/Fax

Practice location:
  • Phone: 402-693-2212
  • Fax: 402-693-2496
Mailing address:
  • Phone: 402-693-2212
  • Fax: 402-693-2496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number254001
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. DIANE I FALK
Title or Position: ADMINISTRATOR PARKVIEW HOME INC
Credential:
Phone: 402-693-2212