Provider Demographics
NPI:1396210779
Name:SOUTHVIEW OPERATIONS LLC
Entity Type:Organization
Organization Name:SOUTHVIEW OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-434-2689
Mailing Address - Street 1:2000 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-4662
Mailing Address - Country:US
Mailing Address - Phone:651-554-9500
Mailing Address - Fax:
Practice Address - Street 1:2000 OAKDALE AVENUE
Practice Address - Street 2:
Practice Address - City:WEST ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118
Practice Address - Country:US
Practice Address - Phone:651-554-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility