Mountain Ridge Complete Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MOUNTAIN RIDGE COMPLETE CARE

Practice address

3159 Carpenters Park Rd
Davidsville, PA 15928-9223

Phone

(814) 243-0414

Fax

(814) 479-5906

NPI assigned

Nov 16, 2022

Last updated

Nov 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia Griesheimer

Title

Coo

Phone

(814) 243-0414

Specialties & licenses 7

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1750090916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3159 CARPENTERS PARK RD",
            "city": "DAVIDSVILLE",
            "state": "PA",
            "postal_code": "159289223",
            "telephone_number": "814-243-0414",
            "fax_number": "814-479-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3159 CARPENTERS PARK RD",
            "city": "DAVIDSVILLE",
            "state": "PA",
            "postal_code": "159289223",
            "telephone_number": "814-243-0414",
            "fax_number": "814-479-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIDGE COMPLETE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "GRIESHEIMER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "814-243-0414"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.completefc.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3159 Carpenters Park Rd",
            "city": "Davidsville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "159289223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rena M. Kuzneski, O.T.
• Ernest James Mantini, D.M.D.
• Rocco Michael Mantini, D.M.D.
• Michael Montag, D.P.T.
• Kimiko Moore
• Northstar Mental Health
• Painted Desert Psychiatry
• Peaceful Hearts,
• Erin Maureen Rhoads, MPT
• Paul M Romanchock, PT

• Primary Care Clinic/Center in Davidsville, PA
• Providers in Davidsville, PA by specialty
• Primary Care Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.