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General NPI Number Information
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NPI Number | 1184749863
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Entity Type | Organization
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Legal Business Name | BONNIE KOLDEN DBA PLEASANT VIEW PERSONAL CARE HOME
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 4322 W CENTRAL AVE
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City | MISSOULA
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State | MT
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Zip | 59804-6216
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Country | US
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Telephone | 406-728-8675
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Fax |
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Provider Business Mailing Address
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Address Line | 4322 W CENTRAL AVE
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City | MISSOULA
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State | MT
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Zip | 59804-6216
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Country | US
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Telephone | 406-728-8675
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BONNIE KOLDEN
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Credential |
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Telephone | 406-728-8675
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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 | 10747
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License Number State | MT
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