Prairie View Skilled Nursing Llc

NPI Registration Record

Provider / Organization	NPI	Date Certified
PRAIRIE VIEW SKILLED NURSING LLC	1477008779	2016-08-17

The organization Prairie View Skilled Nursing Llc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1477008779. Registration indicates Prairie View Skilled Nursing Llc is a provider of access to skilled nursing facilities services with a specialization in Nursing & Custodial Care Facilities, Skilled Nursing Facility (Nursing & Custodial Care Facilities, Skilled Nursing Facility) (Skilled Nursing Facility, ) (All Other Specialties & Provider Types, ) (Skilled Nursing Facility, Nursing & Custodial Care Facilities)

Other Names:

• BLOOMFIELD LIVING CENTER
• Prairie View Skilled Nursing

Entity Type	Organization
Provider Organization	PRAIRIE VIEW SKILLED NURSING LLC
Other Provider Organization	PRAIRIE VIEW SKILLED NURSING
Practice Office Address	606 W MISSOURI ST BLOOMFIELD, MO US
Practice Office Telephone	5735682137
Practice Office Fax	5735689906
Mailing Address	606 W MISSOURI ST BLOOMFIELD, MO 638259706 US
Business Telephone	5735682137
Business Fax	5735689906
Authorized Official	BENJAMIN P SELLS, CEO 5737033049

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