Organization
LOGAN-MINGO AREA MENTAL HEALTH, INC
Active
Other names
Mountain Laurel Integrated Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA L ROBERTSON (FINANCE DIRECTOR)
(304) 792-7130
Entity
Organization
Contact information
Practice address
174 LMAH CENTER RD, LOGAN, WV 25601-4058
(304) 792-7130
(304) 896-5184
Mailing address
PO BOX 176, LOGAN, WV 25601-0176
(304) 792-7130
(304) 896-5184
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5059060
NCPDP
—
01
—
SP0552603
PHARMACY LICENSE
WV
Enumeration date
05/04/2023
Last updated
03/11/2026
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