Provider Demographics
NPI:1598136608
Name:MOUNTAIN VIEW HOME CARE INC.
Entity Type:Organization
Organization Name:MOUNTAIN VIEW HOME CARE INC.
Other - Org Name:MOUNTAIN VIEW HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:719-345-1794
Mailing Address - Street 1:3724 W QUIET CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-2053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 POTTER DR STE 205
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3500
Practice Address - Country:US
Practice Address - Phone:719-452-0151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04F113253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28370252Medicaid