Provider Demographics
NPI:1790186526
Name:PARKVIEW RETIREMENT CENTER, INC.
Entity type:Organization
Organization Name:PARKVIEW RETIREMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:919-774-4322
Mailing Address - Street 1:PO BOX 4057
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-4057
Mailing Address - Country:US
Mailing Address - Phone:919-774-4322
Mailing Address - Fax:919-774-6482
Practice Address - Street 1:1801 WICKER ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-7782
Practice Address - Country:US
Practice Address - Phone:919-774-4322
Practice Address - Fax:919-774-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-053-004310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility