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Organization
MOUNTAIN NURSING CARE SERVICES
Active
Organization
MOUNTAIN NURSING CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA PHILLIPS RN (ADMINISTRATOR)
(909) 338-0448
Entity
Organization
Contact information
Practice address
23493 CREST FOREST DR, CRESTLINE, CA 92325-4119
(909) 338-0448
Mailing address
PO BOX 4119, CRESTLINE, CA 92325-4119
(909) 338-0448
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
240000663
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5504240
—
CA
Enumeration date
10/23/2009
Last updated
06/05/2013
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