# LITTLE MOUNTAIN HEALTHCARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mira Vista Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578149233
- **Authorized official:** SOON BURNAM (TREASURER)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 300 S 18TH ST, MOUNT VERNON, WA 98274-4661
- **Practice address phone:** (360) 424-1320
- **Practice address fax:** (360) 848-1948
- **Mailing address:** 300 S 18TH ST, MOUNT VERNON, WA 98274-4661
- **Mailing address phone:** (360) 424-1320
- **Mailing address fax:** (360) 848-1948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/23/2021
- **Last updated:** 02/17/2022