Healthcare Provider Details

I. General information

NPI: 1952433112
Provider Name (Legal Business Name): MOUNTAIN HORIZON OF HOPE,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1979 N KY HIGHWAY 15 STE 3
HAZARD KY
41701-5620
US

IV. Provider business mailing address

1979 N KY HWY 15 SOUTH SUITE# 3 PO BOX 761 HAZARD
KENTUCKY KY
41702
US

V. Phone/Fax

Practice location:
  • Phone: 606-487-1860
  • Fax: 606-487-0119
Mailing address:
  • Phone: 606-487-1860
  • Fax: 606-487-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. JACQUELINE S. TAYLOR
Title or Position: COMPANY TROLLER
Credential:
Phone: 606-487-1863