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General NPI Number Information
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NPI Number | 1811981046
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Entity Type | Organization
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Legal Business Name | PARK VIEW HOME, INC.
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 N LOCKWOOD ST
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City | WOODVILLE
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State | WI
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Zip | 54028-9577
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Country | US
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Telephone | 715-698-2451
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Fax | 715-698-2363
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Provider Business Mailing Address
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Address Line | 220 N LOCKWOOD ST PO BOX 265
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City | WOODVILLE
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State | WI
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Zip | 54028-9577
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Country | US
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Telephone | 715-698-2451
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Fax | 715-698-2363
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Authorized Official
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Title or Position | ADMNISTRATOR
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Name | MELISSA M WALTHALL
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Credential | NHA
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Telephone | 715-698-2451
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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 | 859
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License Number State | WI
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