Provider Demographics
NPI:1093371155
Name:MOUNTAIN VIEW SD SKILLED NURSING FACILITY LLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW SD SKILLED NURSING FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJCHENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-679-9797
Mailing Address - Street 1:3450 OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2951
Mailing Address - Country:US
Mailing Address - Phone:847-679-9797
Mailing Address - Fax:847-679-1126
Practice Address - Street 1:916 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2521
Practice Address - Country:US
Practice Address - Phone:605-343-8577
Practice Address - Fax:605-343-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility