- Enrollment id
- O20170413001599
- Enrollment state
- CO
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1114459039
- Multiple npi flag
- N
- Ccn
- 065181
- Associate id
- 0547546111
- Organization name
- VALLEY VIEW VILLA OPERATIONS LLC
- Doing business as name
- VALLEY VIEW VILLA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- VALLEY VIEW VILLA
- Affiliation entity name
- LIFE CARE CENTERS OF AMERICA
- Affiliation entity id
- 311
- Address line 1
- 815 FREMONT AVE
- City
- FORT MORGAN
- State
- CO
- Zip code
- 807013553