# LONGMONT-MOUNTAIN VIEW SURGERY CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780130252
- **Authorized official:** JENETHA D MORAN (OFFICER / AUTHORIZED OFFICIAL)
- **Authorized official phone:** (972) 763-3893

## Contact information

- **Practice address:** 2030 MOUNTAIN VIEW AVE, SUITE 100, LONGMONT, CO 80501-3178
- **Practice address phone:** (972) 763-3893
- **Practice address fax:** (972) 692-6745
- **Mailing address:** 15305 DALLAS PKWY, SUITE 1600, ADDISON, TX 75001-4637
- **Mailing address phone:** (972) 763-3893
- **Mailing address fax:** (972) 692-6745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/25/2016
- **Last updated:** 11/27/2017