Provider Demographics
NPI:1437151610
Name:VALLEYVIEW MANOR NURSING HOME
Entity Type:Organization
Organization Name:VALLEYVIEW MANOR NURSING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-888-2923
Mailing Address - Street 1:200 9TH AVE E
Mailing Address - Street 2:
Mailing Address - City:LAMBERTON
Mailing Address - State:MN
Mailing Address - Zip Code:56152-1024
Mailing Address - Country:US
Mailing Address - Phone:507-752-7346
Mailing Address - Fax:507-752-7348
Practice Address - Street 1:200 9TH AVE E
Practice Address - Street 2:
Practice Address - City:LAMBERTON
Practice Address - State:MN
Practice Address - Zip Code:56152-1024
Practice Address - Country:US
Practice Address - Phone:507-752-7346
Practice Address - Fax:507-752-7348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN326611314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN425340000Medicaid
MN425340000Medicaid