| Organization Name: | MOUNTAIN HOSPICE INC |
| NPI Number: | 1548253735 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD TRIMBLE (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 1002 S Crim Ave Belington |
| State: | WV US |
| Postal Code: | 262508203 |
| Phone Number: | 3048233922 |
| Fax Number: | 3048233926 |
| NPI Enumeration Date: | 08/24/2005 |
| NPI Last Update Date: | 06/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 22932194 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |