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General NPI Number Information
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NPI Number | 1306396312
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Entity Type | Organization
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Legal Business Name | MOUNTAIN CONNECTIONS, INC.
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 421 LAUREL ST
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City | WEBER CITY
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State | VA
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Zip | 24290-7275
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Country | US
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Telephone | 276-386-7146
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Fax | 276-386-7315
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Provider Business Mailing Address
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Address Line | 421 LAUREL ST
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City | WEBER CITY
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State | VA
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Zip | 24290-7275
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Country | US
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Telephone | 276-386-7146
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Fax | 276-386-7315
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LINDA F HORNE
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Credential |
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Telephone | 276-386-7146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 907-01-001
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License Number State | VA
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