Mountain Vista Health Park, Inc.

Organization Active NPI Adult Care Home Facility · Denton, NC

NPI 1710997804 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1710997804
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
NH0259 (NC)
Legal business name
MOUNTAIN VISTA HEALTH PARK, INC.
Practice address
106 Mt Vista Rd
Denton, NC 27239-8793
Phone
(336) 859-2181
Fax
(336) 859-4053
NPI assigned
Aug 9, 2006
Organization subpart
No

Authorized official

Name
Mrs. Kathy B McDonald
Title
Administrator
Phone
(336) 859-2181

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Mountain Vista Health Park (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NH0259 NC Yes

Addresses

Primary practice location

106 Mt Vista Rd
Denton, NC 27239-8793

Mailing address

PO Box 1547
Denton, NC 27239-1547
Phone (336) 859-2181

Other identifiers

IdentifierTypeStateIssuer
7801373MedicaidNC

Other names

  • MOUNTAIN VISTA HEALTH PARK Doing business as

Other providers in Denton, NC

All providers in Denton, NC · Adult Care Home Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.