Provider Demographics
NPI:1982214607
Name:PARKVIEW MANOR INC
Entity Type:Organization
Organization Name:PARKVIEW MANOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSONOWO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:612-702-7412
Mailing Address - Street 1:10643 WELCOME BAY N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3268
Mailing Address - Country:US
Mailing Address - Phone:612-702-7412
Mailing Address - Fax:612-314-8840
Practice Address - Street 1:5802 BASS LAKE RD
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55429-2749
Practice Address - Country:US
Practice Address - Phone:612-702-7412
Practice Address - Fax:612-314-8840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness