Healthcare Provider Details

I. General information

NPI: 1295722353
Provider Name (Legal Business Name): VALLEY VIEW HAVEN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 01/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4702 E MAIN ST
BELLEVILLE PA
17004-9251
US

IV. Provider business mailing address

4702 E MAIN ST
BELLEVILLE PA
17004-9251
US

V. Phone/Fax

Practice location:
  • Phone: 717-935-2105
  • Fax: 171-935-5109
Mailing address:
  • Phone: 717-935-2105
  • Fax: 171-935-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number335520
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number220402
License Number StatePA

VIII. Authorized Official

Name: MR. ALLEN WILLIAM HESS
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 717-935-2105