Provider Demographics
NPI:1003023862
Name:VALLEY VIEW ESTATES
Entity Type:Organization
Organization Name:VALLEY VIEW ESTATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-692-6642
Mailing Address - Street 1:1104 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LONG PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56347-0008
Mailing Address - Country:US
Mailing Address - Phone:320-732-3516
Mailing Address - Fax:320-732-7018
Practice Address - Street 1:1104 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-0008
Practice Address - Country:US
Practice Address - Phone:320-732-3516
Practice Address - Fax:320-732-7018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN333226310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility