Organization
VALLEYVIEW OF JORDAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALAINA GAST (ADMINISTRATOR)
(952) 492-6160
Entity
Organization
Contact information
Practice address
4061 W 173RD ST, JORDAN, MN 55352-8318
(952) 492-6160
Mailing address
4061 W 173RD ST, JORDAN, MN 55352-8318
(952) 492-6160
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20964
—
MN
Enumeration date
03/05/2019
Last updated
03/05/2019
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