Organization
MOUNTAIN VIEW RESIDENTIAL HOME - A WATERS COMMUNITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BLISKO (MBR)
(708) 449-1900
Entity
Organization
Contact information
Practice address
414 MASSEY AVE, MOUNTAIN VIEW, AR 72560-6132
(870) 269-5845
Mailing address
414 MASSEY AVE, MOUNTAIN VIEW, AR 72560-6132
(870) 269-5845
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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