MEDICARE: GRAND VIEW CARE CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility
2	314000000X	Skilled Nursing Facility	2893	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659372977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAND VIEW CARE CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 27
Second Line	:
City	:	BLAIR
State	:	WI
Zip	:	54616-0027
Country	:	US
Telephone Number	:	608-989-2511
Fax Number	:	608-989-2679

Provider Business Practice Location Address
First Line	:	620 GRAND VIEW AVE
Second Line	:
City	:	BLAIR
State	:	WI
Zip	:	54616
Country	:	US
Telephone Number	:	608-989-2511
Fax Number	:	608-989-2679

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LEAH KATHERINE STEELE
Credential	:	NHA
Telephone Number	:	608-989-2511

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	02/22/2023

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