Organization
MOUNTAIN CAP OF WV INC A CDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WALKER (PROGRAM DIRECTOR)
(304) 765-7738
Entity
Organization
Contact information
Practice address
26 N KANAWHA ST, BUCKHANNON, WV 26201-2714
(304) 765-7738
Mailing address
26 N KANAWHA ST, BUCKHANNON, WV 26201-2714
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003013
—
WV
Enumeration date
11/01/2006
Last updated
08/22/2020
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