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Organization

COUNCIL OF THE SOUTHERN MOUNTAINS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RANDAL JOHNSON M.A. (EXECUTIVE DIRECTOR)
(304) 436-6800
Entity
Organization

Contact information

Practice address
148 MCDOWELL ST, WELCH, WV 24801-2225
(304) 436-6800
(304) 436-6803
Mailing address
148 MCDOWELL ST, WELCH, WV 24801-2225
(304) 436-6800
(304) 436-6803

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
384
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1881716611
WV
Enumeration date
04/04/2013
Last updated
04/30/2013
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