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General NPI Number Information
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NPI Number | 1982989604
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Entity Type | Organization
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Legal Business Name | MOUNTAIN HOME CARE LLC
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 2270 HENDERSONVILLE RD SUITE #3
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City | ARDEN
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State | NC
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Zip | 28704-2753
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Country | US
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Telephone | 828-684-6444
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Fax | 828-684-6499
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Provider Business Mailing Address
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Address Line | PO BOX 517
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City | ARDEN
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State | NC
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Zip | 28704-0517
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Country | US
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Telephone | 828-684-6444
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Fax | 828-684-6499
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ARLANA AULL WILDE
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Credential | CSA
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Telephone | 828-684-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HC3777
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License Number State | NC
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