Provider Demographics
NPI:1437283660
Name:LONGVIEW ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:LONGVIEW ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PUETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-437-6846
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-0548
Mailing Address - Country:US
Mailing Address - Phone:828-437-6846
Mailing Address - Fax:828-437-6875
Practice Address - Street 1:2001 BRISTOL CREEK AVE
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655
Practice Address - Country:US
Practice Address - Phone:828-437-6846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-012-022310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7804698Medicaid