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General NPI Number Information
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NPI Number | 1023097151
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Entity Type | Organization
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Legal Business Name | FOUNTAIN VIEW INC
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1001A JEFFERSON ST
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City | ELDORADO
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State | IL
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Zip | 62930-1373
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Country | US
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Telephone | 618-273-3353
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Fax | 618-273-4800
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Provider Business Mailing Address
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Address Line | 1001A JEFFERSON ST
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City | ELDORADO
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State | IL
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Zip | 62930-1373
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Country | US
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Telephone | 618-273-3353
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Fax | 618-273-4800
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DENISE LUCKETT
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Credential |
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Telephone | 618-273-3353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0020628
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 0020628
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License Number State | IL
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