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General NPI Number Information
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NPI Number | 1932326121
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Entity Type | Organization
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Legal Business Name | MOUNTAINHEART COMMUNITY SERVICES, INC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | RURAL RT 85
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City | KOPPERSTON
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State | WV
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Zip | 24854
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Country | US
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Telephone | 304-682-8271
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1509
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City | OCEANA
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State | WV
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Zip | 24870-1509
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Country | US
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Telephone | 304-682-8271
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | EARL SMITH
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Credential |
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Telephone | 304-682-8271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 001
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License Number State | WV
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