Organization
MOUNTAIN CREEK HOME HEALTH, INC.
Active
Other names
Mountain Creek Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JOHNSON (PRESIDENT)
(423) 478-5958
Entity
Organization
Contact information
Practice address
601 S ALBERT AVE, WALSENBURG, CO 81089-2246
(719) 738-5707
(719) 738-1933
Mailing address
601 S ALBERT AVE, WALSENBURG, CO 81089-2246
(719) 738-5707
(719) 738-1933
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24382868
—
CO
Enumeration date
05/19/2006
Last updated
08/22/2020
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