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Organization

LIFECARE MOUNTAIN HOME CARE LLC

Active
Other names
Mountain Home Care
Organization subpart
No

Provider details

NPI number
Authorized official
JONNY FUNSTON (CFO)
(706) 877-0838
Entity
Organization

Contact information

Practice address
1150 WASHINGTON AVENUE, SUITE 215, SANTE FE, NM 87501
(972) 982-7290
(469) 331-0387
Mailing address
PO BOX 733707, DALLAS, TX 75373-3707
(972) 982-7290
(469) 331-0387

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Enumeration date
07/18/2023
Last updated
07/18/2023
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