Organization
LOGAN MINGO AREA MENTAL HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA L ROBERTSON (BENEFITS COORDINATOR)
(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
208D00000X
General Practice Physician
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/15/2019
Last updated
08/15/2024
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