Provider Demographics
NPI:1851757744
Name:CV SNF LLC
Entity Type:Organization
Organization Name:CV SNF LLC
Other - Org Name:CROSSVIEW CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WERTHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-919-7204
Mailing Address - Street 1:402 BAY ST E
Mailing Address - Street 2:
Mailing Address - City:PINEVIEW
Mailing Address - State:GA
Mailing Address - Zip Code:31071-3430
Mailing Address - Country:US
Mailing Address - Phone:229-624-2437
Mailing Address - Fax:229-624-2715
Practice Address - Street 1:402 BAY ST E
Practice Address - Street 2:
Practice Address - City:PINEVIEW
Practice Address - State:GA
Practice Address - Zip Code:31071-3430
Practice Address - Country:US
Practice Address - Phone:229-624-2437
Practice Address - Fax:229-624-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
115541Medicare Oscar/Certification