Organization
MOUNTAIN HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY SRIVASTAVA (ORGANIZER)
(606) 793-4510
Entity
Organization
Contact information
Practice address
3056 KY ROUTE 321, PRESTONSBURG, KY 41653-9105
(606) 793-4510
Mailing address
PO BOX 494, HAGERHILL, KY 41222-0494
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/09/2020
Last updated
12/14/2020
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