Mountain Health & Community Services, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

090000135 Issued in CA

Legal business name

MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.

Practice address

3291 Buckman Springs Rd
Pine Valley, CA 91962-4003

Phone

(619) 473-8601

Fax

(619) 478-2267

NPI assigned

Nov 16, 2007

Organization subpart

No

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

Authorized official

Name

Judith Shaplin

Title

Ceo

Phone

(619) 445-6200

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mountain Empire School Clinic Doing business as

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1326229477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31115 HIGHWAY 94",
            "city": "CAMPO",
            "state": "CA",
            "postal_code": "919063133",
            "telephone_number": "619-478-5254",
            "fax_number": "619-478-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 BUCKMAN SPRINGS RD",
            "city": "PINE VALLEY",
            "state": "CA",
            "postal_code": "919624003",
            "telephone_number": "619-473-8601",
            "fax_number": "619-478-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "SHAPLIN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-445-6200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "090000135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PROGRAM",
            "identifier": "BCP03814F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC03814F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PROGRAM",
            "identifier": "HAP03814F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Empire School Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaela M Knight
• Peter William Krahling
• McAlister Institute for Treatment & Education, Inc.
• Jo Emery Miller, LCSW
• Mountain Empire Usd
• Josefina Munoz
• Pine Valley Fire Protection District
• Aaron Brian Pitts, DMD
• Trishauna Pulos
• Valori Sharp

• Federally Qualified Health Center (FQHC) in Pine Valley, CA
• Providers in Pine Valley, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.