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General NPI Number Information
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NPI Number | 1003023862
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Entity Type | Organization
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Legal Business Name | VALLEY VIEW ESTATES
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1104 4TH AVE NE
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City | LONG PRAIRIE
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State | MN
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Zip | 56347-0008
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Country | US
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Telephone | 320-732-3516
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Fax | 320-732-7018
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Provider Business Mailing Address
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Address Line | 1104 4TH AVE NE
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City | LONG PRAIRIE
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State | MN
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Zip | 56347-0008
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Country | US
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Telephone | 320-732-3516
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Fax | 320-732-7018
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Authorized Official
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Title or Position | OWNER
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Name | CHUCK LANE
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Credential |
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Telephone | 218-692-6642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 333226
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License Number State | MN
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