1851347033 NPI number — VALLEY VIEW HEALTH AND REHABILITATION, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851347033 NPI number — VALLEY VIEW HEALTH AND REHABILITATION, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY VIEW HEALTH AND REHABILITATION, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851347033
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5968 WALL TRIANA HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35757-7200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-830-2316
Provider Business Mailing Address Fax Number:
256-830-2319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5968 WALL TRIANA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35757-7200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-830-2316
Provider Business Practice Location Address Fax Number:
256-830-2319
Provider Enumeration Date:
05/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LONG
Authorized Official First Name:
PHILLIP
Authorized Official Middle Name:
CODY
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
205-391-3600

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4757980S , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012431 . This is a "BCBS ID" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".