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General NPI Number Information
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NPI Number | 1952185779
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Entity Type | Organization
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Legal Business Name | MOUNTAIN CARE LLC
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 1919 H ST APT C
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City | LAS VEGAS
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State | NV
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Zip | 89106-2544
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Country | US
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Telephone | 725-251-3362
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Fax | 702-549-1915
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Provider Business Mailing Address
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Address Line | 2300 W SAHARA AVE STE 800
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City | LAS VEGAS
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State | NV
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Zip | 89102-4397
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ABDUL COOPER
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Credential |
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Telephone | 510-393-5306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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