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General NPI Number Information
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NPI Number | 1124101191
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW RETIREMENT HOME INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | ROUTE 660 2336 COAL TIPPLE HALLAR
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City | LEBANON
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State | VA
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Zip | 24266
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Country | US
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Telephone | 276-889-3611
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Fax | 276-889-2284
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Provider Business Mailing Address
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Address Line | PO BOX 1148
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City | LEBANON
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State | VA
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Zip | 24266
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Country | US
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Telephone | 276-889-3611
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Fax | 276-889-2284
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Authorized Official
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Title or Position | DON
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Name | LINDA LOU MAYS
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Credential |
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Telephone | 276-889-3611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | VA
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