Provider Demographics
NPI:1093988768
Name:MOUNTAIN VALLEY
Entity Type:Organization
Organization Name:MOUNTAIN VALLEY
Other - Org Name:MOUNTAIN VALLEY HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-728-6574
Mailing Address - Street 1:920 HERITAGE PARK BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5638
Mailing Address - Country:US
Mailing Address - Phone:801-728-6574
Mailing Address - Fax:801-728-6575
Practice Address - Street 1:920 HERITAGE PARK BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5638
Practice Address - Country:US
Practice Address - Phone:801-728-6574
Practice Address - Fax:801-728-6575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health