OrganizationMountain MomentsClinic/CenterAmbulatory Health Care FacilitiesPractice Address1154 Center Dr Ste D250, Park City, UT 84098-1258(206) 795-4360PECOS EnrollmentBased on the most recent information from CMS, provider Mountain Moments does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1306466636Provider TypeOrganizationFull NameMountain MomentsSubpartNoEnumeration Date4/16/2020Last Updated4/16/2020Contact InformationPractice LocationPractice Address1154 Center Dr Ste D250, Park City, UT 84098-1258Phone(206) 795-4360FaxUnlisted FaxMailing LocationMailing AddressPO Box 683745, Park City, UT 84068-3745PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameBrooks, Carly (Ceo/Founder)Phone(206) 795-4360Provider TaxonomiesCodeDescriptionLicenseCode261QH0100XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted Issuer