Provider Demographics
NPI:1528187135
Name:MOUNTAIN CONNECTIOINS, INC.
Entity Type:Organization
Organization Name:MOUNTAIN CONNECTIOINS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR QMRP
Authorized Official - Prefix:
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 1:114 LAUREL STREET
Mailing Address - Street 2:
Mailing Address - City:WEBER CITY
Mailing Address - State:VA
Mailing Address - Zip Code:24290
Mailing Address - Country:US
Mailing Address - Phone:276-386-7146
Mailing Address - Fax:276-386-7315
Practice Address - Street 1:114 LAUREL STREET
Practice Address - Street 2:
Practice Address - City:WEBER CITY
Practice Address - State:VA
Practice Address - Zip Code:24290
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:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA907320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities