MEDICARE: AMERICAN LUTHERAN CHURCH VALLEY VIEW HOME

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	9958	MT
2	261QA0600X	Adult Day Care Clinic/Center	9921	MT
3	313M00000X	Nursing Facility/Intermediate Care Facility	9958	MT

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	:	1831199314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN LUTHERAN CHURCH VALLEY VIEW HOME

Provider Business Mailing Address
First Line	:	1225 PERRY LN
Second Line	:
City	:	GLASGOW
State	:	MT
Zip	:	59230-1532
Country	:	US
Telephone Number	:	406-228-2461
Fax Number	:	406-228-4831

Provider Business Practice Location Address
First Line	:	1225 PERRY LN
Second Line	:
City	:	GLASGOW
State	:	MT
Zip	:	59230-1532
Country	:	US
Telephone Number	:	406-228-2461
Fax Number	:	406-228-4831

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	FRANK W THOMPSON
Credential	:	NAB
Telephone Number	:	406-228-2461

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	11/22/2021

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