Provider Demographics
NPI:1235105834
Name:COUNTY OF BLAIR
Entity Type:Organization
Organization Name:COUNTY OF BLAIR
Other - Org Name:VALLEY VIEW HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-944-0845
Mailing Address - Street 1:301 VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6409
Mailing Address - Country:US
Mailing Address - Phone:814-944-0845
Mailing Address - Fax:814-941-3798
Practice Address - Street 1:301 VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-6409
Practice Address - Country:US
Practice Address - Phone:814-944-0845
Practice Address - Fax:814-941-3798
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF BLAIR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-24
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA480502/PI314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007486780001Medicaid
PA0467OtherHIGHMARK BLUE
PA1007486780001Medicaid