Organization
MOUNTAINEER HOMECARE, LLC
Active
Other names
Mountaineer HomeCare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA L PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
400 TRACY WAY STE 100, CHARLESTON, WV 25311-1280
(304) 720-0205
(304) 720-0262
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 443-4154
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810013957
—
WV
Enumeration date
08/04/2008
Last updated
08/23/2024
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