Provider Demographics
NPI:1821360868
Name:VALLEY VIEW HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:VALLEY VIEW HEALTH SERVICES, INC.
Other - Org Name:MONTE VISTA HILLS HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:1071 RENEE AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-2508
Mailing Address - Country:US
Mailing Address - Phone:208-233-1411
Mailing Address - Fax:208-233-1515
Practice Address - Street 1:1071 RENEE AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-2508
Practice Address - Country:US
Practice Address - Phone:208-233-1411
Practice Address - Fax:208-233-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID135018Medicare Oscar/Certification