NPI 1811707797
Mountaintop LLC
Practice location
- Address
- 9890 N Hillview Dr, Hayden, ID 83835-9508
- Phone
- (208) 518-3868
- Mailing address
- PO Box 3003, Hayden, ID 83835-3003
Authorised official
- Name
- Jason Thomas Underdahl
- Title
- Chief Administrative Officer
- Phone
- (208) 262-1885
Registered specialties (2)
Mental Illness Community Based Residential Treatment Facility
Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Registry record
- NPI
- 1811707797
- Entity type
- Organization
- NPI issued
- 13 Jan 2025
- Record last updated
- 13 Jan 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.