Healthcare Provider Details

I. General information

NPI: 1437078243
Provider Name (Legal Business Name): MOUNTAIN OUTREACH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3198 STATE HIGHWAY 343
MCROBERTS KY
41835
US

IV. Provider business mailing address

PO BOX 271
NEON KY
41840-0271
US

V. Phone/Fax

Practice location:
  • Phone: 606-832-9026
  • Fax:
Mailing address:
  • Phone: 606-832-9026
  • Fax: 606-832-9026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DIANE MORRIS
Title or Position: DIRECTOR
Credential:
Phone: 606-832-9026