Provider Demographics
NPI:1750702684
Name:SURMOUNT, INC.
Entity type:Organization
Organization Name:SURMOUNT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HELFERS
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:502-272-4400
Mailing Address - Street 1:710 JARVIS WOODS TER
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-3509
Mailing Address - Country:US
Mailing Address - Phone:502-272-4400
Mailing Address - Fax:502-272-4401
Practice Address - Street 1:4965 US HIGHWAY 42 STE 1000
Practice Address - Street 2:FENLEY OFFICE BUILDING
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-6375
Practice Address - Country:US
Practice Address - Phone:502-272-4400
Practice Address - Fax:502-272-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251V00000X
KYPSA500133253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable