Healthcare Provider Details

I. General information

NPI: 1164040168
Provider Name (Legal Business Name): MOUNTAIN VIEW SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 TREVORTON ROAD
COAL TOWNSHIP PA
17866-9405
US

IV. Provider business mailing address

2050 TREVORTON ROAD
COAL TOWNSHIP PA
17866-9405
US

V. Phone/Fax

Practice location:
  • Phone: 570-644-4400
  • Fax: 570-644-4403
Mailing address:
  • Phone: 570-644-4400
  • Fax: 570-644-4403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAIM STEG
Title or Position: OWNER
Credential:
Phone: 732-267-9679