Mountaineer Home Healthcare Agency, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MOUNTAINEER HOME HEALTHCARE AGENCY, LLC

Practice address

4614 Prospect Ave
421
Cleveland, OH 44103-4394

Phone

(216) 881-5588

Fax

(216) 881-5995

NPI assigned

Nov 11, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ethel Augustus

Title

Ceo

Phone

(216) 799-6689

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415664000000",
    "number": "1063818599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 PROSPECT AVE",
            "address_2": "421",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034394",
            "telephone_number": "216-881-5588",
            "fax_number": "216-881-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4614 PROSPECT AVE",
            "address_2": "421",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034394",
            "telephone_number": "216-881-5588",
            "fax_number": "216-881-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINEER HOME HEALTHCARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A",
        "authorized_official_last_name": "AUGUSTUS",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-799-6689",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Nicole Moultry, STNA
• Shannon Dominique Moultry, LPN
• Mount Horeb Homecare LLC
• William Mount, LPC
• Mountaineer Home Healthcare Agency
• Annika Mounts, MD
• Ronda Mourad, M.D.
• Elyssa Mourany, DDS
• Ahmad Mousa
• Haytham Mously

• Home Health Agency in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.