Provider Demographics
NPI:1578583399
Name:MOUNTAINVIEW HOME HEALTH, LLC
Entity Type:Organization
Organization Name:MOUNTAINVIEW HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PESEK
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:509-576-0800
Mailing Address - Street 1:409 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-2336
Mailing Address - Country:US
Mailing Address - Phone:509-576-0800
Mailing Address - Fax:509-452-0936
Practice Address - Street 1:409 N 2ND ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2336
Practice Address - Country:US
Practice Address - Phone:509-576-0800
Practice Address - Fax:509-452-0936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-090251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9056847OtherMEDICAID DME
WA9056292Medicaid
WA197108OtherLABOR & INDUSTRIES
WA507115Medicare UPIN