Provider Demographics
NPI:1952481491
Name:PARKVIEW HOME INC
Entity Type:Organization
Organization Name:PARKVIEW HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR PARKVIEW HOME INC
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:I
Authorized Official - Last Name:FALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-693-2212
Mailing Address - Street 1:930 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DODGE
Mailing Address - State:NE
Mailing Address - Zip Code:68633-3555
Mailing Address - Country:US
Mailing Address - Phone:402-693-2212
Mailing Address - Fax:402-693-2496
Practice Address - Street 1:930 2ND ST
Practice Address - Street 2:
Practice Address - City:DODGE
Practice Address - State:NE
Practice Address - Zip Code:68633-3555
Practice Address - Country:US
Practice Address - Phone:402-693-2212
Practice Address - Fax:402-693-2496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE254001314000000X
332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE60103OtherBCBS
NE47039803900Medicaid
0648120001Medicare NSC
NE47039803900Medicaid