Provider Demographics
NPI:1023666898
Name:MOUNTAIN MENTAL HEALTH
Entity type:Organization
Organization Name:MOUNTAIN MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WINDSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:559-267-3552
Mailing Address - Street 1:40680 HIGHWAY 41 STE D
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644-9657
Mailing Address - Country:US
Mailing Address - Phone:559-267-3552
Mailing Address - Fax:209-317-4020
Practice Address - Street 1:5320 HIGHWAY 49 N
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9588
Practice Address - Country:US
Practice Address - Phone:559-267-3552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty