Provider Demographics
NPI:1376648790
Name:MOUNTAIN VALLEY HOSPICE, INC
Entity Type:Organization
Organization Name:MOUNTAIN VALLEY HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEECHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-476-4410
Mailing Address - Street 1:1186 E 4600 S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4332
Mailing Address - Country:US
Mailing Address - Phone:801-476-4410
Mailing Address - Fax:801-476-4186
Practice Address - Street 1:1186 E 4600 S
Practice Address - Street 2:SUITE 200
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4332
Practice Address - Country:US
Practice Address - Phone:801-476-4410
Practice Address - Fax:801-476-4186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based