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General NPI Number Information
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NPI Number | 1700275948
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Entity Type | Organization
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Legal Business Name | MOUNTAINVIEW MEADOWS AID OPCO LLC
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 1008 E MOUNTAIN VIEW AVE
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City | ELLENSBURG
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State | WA
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Zip | 98926-3940
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Country | US
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Telephone | 509-925-4484
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Fax |
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Provider Business Mailing Address
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Address Line | 330 N WABASH AVE SUITE 3700
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City | CHICAGO
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State | IL
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Zip | 60611-3586
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Country | US
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Telephone | 312-725-7072
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DANIEL GUILL
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Credential |
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Telephone | 312-725-7072
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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 | 2186
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License Number State | WA
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