Healthcare Provider Details

I. General information

NPI: 1326563271
Provider Name (Legal Business Name): MH HEALTH CARE SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 08/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 WAPITI CT UNIT 201A
RIFLE CO
81650-3444
US

IV. Provider business mailing address

PO BOX 5
WINOOSKI VT
05404-0005
US

V. Phone/Fax

Practice location:
  • Phone: 970-440-8085
  • Fax:
Mailing address:
  • Phone: 802-857-0434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NANCY CARLSON
Title or Position: PRESIDENT
Credential: MD
Phone: 802-857-0400