Provider Demographics
NPI:1225746555
Name:MOUNTAIN VIEW HOME HEALTHCARE LLC.
Entity type:Organization
Organization Name:MOUNTAIN VIEW HOME HEALTHCARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:KELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-223-0012
Mailing Address - Street 1:6953 SW 36TH DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6666
Mailing Address - Country:US
Mailing Address - Phone:754-223-0012
Mailing Address - Fax:
Practice Address - Street 1:7971 RIVIERA BLVD STE 328
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6449
Practice Address - Country:US
Practice Address - Phone:786-541-3216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty