Provider Demographics
NPI:1306396312
Name:MOUNTAIN CONNECTIONS, INC.
Entity Type:Organization
Organization Name:MOUNTAIN CONNECTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-386-7146
Mailing Address - Street 1:421 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:WEBER CITY
Mailing Address - State:VA
Mailing Address - Zip Code:24290-7275
Mailing Address - Country:US
Mailing Address - Phone:276-386-7146
Mailing Address - Fax:276-386-7315
Practice Address - Street 1:421 LAUREL ST
Practice Address - Street 2:
Practice Address - City:WEBER CITY
Practice Address - State:VA
Practice Address - Zip Code:24290-7275
Practice Address - Country:US
Practice Address - Phone:276-386-7146
Practice Address - Fax:276-386-7315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA907-01-001320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities