Healthcare Provider Details
I. General information
NPI: 1033971049
Provider Name (Legal Business Name): MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2024
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
116 SEVEN MILE RIDGE RD
BURNSVILLE NC
28714-8509
US
IV. Provider business mailing address
PO BOX 27
BAKERSVILLE NC
28705-0027
US
V. Phone/Fax
- Phone: 828-675-4116
- Fax: 828-675-9312
- Phone: 828-688-2104
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIM
A
EVANS
Title or Position: CEO
Credential:
Phone: 828-675-4116