# MOUNTAINEER HOMECARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mountaineer HomeCare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710143375
- **Authorized official:** MR. JOSHUA L PROFFITT (PRESIDENT)
- **Authorized official phone:** (337) 233-1307

## Contact information

- **Practice address:** 400 TRACY WAY STE 100, CHARLESTON, WV 25311-1280
- **Practice address phone:** (304) 720-0205
- **Practice address fax:** (304) 720-0262
- **Mailing address:** PO BOX 51266, LAFAYETTE, LA 70505-1266
- **Mailing address phone:** (337) 233-1307
- **Mailing address fax:** (337) 443-4154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/04/2008
- **Last updated:** 08/23/2024