Provider Demographics
NPI:1659372977
Name:GRAND VIEW CARE CENTER INC
Entity Type:Organization
Organization Name:GRAND VIEW CARE CENTER INC
Other - Org Name:GRAND VIEW CARE CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:608-989-2511
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:WI
Mailing Address - Zip Code:54616-0027
Mailing Address - Country:US
Mailing Address - Phone:608-989-2511
Mailing Address - Fax:608-989-2679
Practice Address - Street 1:620 GRAND VIEW AVE
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:WI
Practice Address - Zip Code:54616
Practice Address - Country:US
Practice Address - Phone:608-989-2511
Practice Address - Fax:608-989-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
WI2893314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20120900Medicaid
WI525624Medicare ID - Type Unspecified