Healthcare Provider Details

I. General information

NPI: 1790701324
Provider Name (Legal Business Name): MOUNTAIN AREA COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 S MAIN ST
MARION NC
28752-4527
US

IV. Provider business mailing address

366 S MAIN ST
MARION NC
28752-4527
US

V. Phone/Fax

Practice location:
  • Phone: 828-659-1180
  • Fax: 828-659-1182
Mailing address:
  • Phone: 828-659-1180
  • Fax: 828-659-1182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD ARLEN LUTHER JR.
Title or Position: PRESIDENT
Credential:
Phone: 828-659-1180