Provider Demographics
NPI:1386399541
Name:NORTH MOUNTAIN HOME CARE
Entity type:Organization
Organization Name:NORTH MOUNTAIN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-225-8208
Mailing Address - Street 1:2900 W DARLEEN DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-0700
Mailing Address - Country:US
Mailing Address - Phone:928-225-8208
Mailing Address - Fax:928-440-3357
Practice Address - Street 1:2900 W DARLEEN DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-0700
Practice Address - Country:US
Practice Address - Phone:928-225-8208
Practice Address - Fax:928-440-3357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care