Organization
MOUNTAINLIFE HOME CARE, INC.
Active
Other names
MountainLife In-Home Aide Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD W. HAMMITT RN (DIRECTOR/PRESIDENT)
(336) 846-1784
Entity
Organization
Contact information
Practice address
411 S MAIN ST, JEFFERSON, NC 28640-9519
(336) 846-1784
(336) 846-1785
Mailing address
PO BOX 1784, WEST JEFFERSON, NC 28694-1784
(336) 846-1784
(336) 846-1785
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2576
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040720
NC DHHS DFS FACILITY ID
NC
01
—
0719745
NC CORPORATE ID NUMBER
NC
05
—
3408136
—
NC
05
—
6601120
—
NC
Enumeration date
06/20/2005
Last updated
08/22/2020
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