Organization
MOUNTAIN CARE OF SNOWFLAKE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON D JOHNSON (DIRECTOR)
(928) 243-6623
Entity
Organization
Contact information
Practice address
48 E 1ST ST S, SNOWFLAKE, AZ 85937-5336
(928) 536-2726
Mailing address
417 N PEAR, SNOWFLAKE, AZ 85937-5089
(928) 243-6623
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
310400000X
Assisted Living Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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