Organization
MOUNTAINHEART COMMUNITY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL D SMITH (EXECUTIVE DIRECTOR)
(304) 682-8271
Entity
Organization
Contact information
Practice address
33 MOUNTAINHEART LANE, MATHENY, WV 24860
(304) 682-8271
(304) 682-8274
Mailing address
PO BOX 1509, OCEANA, WV 24870-1509
(304) 682-8271
(304) 682-8274
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1035-1099
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810025021
—
WV
Enumeration date
02/11/2015
Last updated
03/02/2015
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