Organization
MOUNTAINHEART COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL SMITH (EXECUTIVE DIRECTOR)
(304) 682-8271
Entity
Organization
Contact information
Practice address
RURAL RT 85, KOPPERSTON, WV 24854
(304) 682-8271
Mailing address
PO BOX 1509, OCEANA, WV 24870-1509
(304) 682-8271
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
001
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030498000
—
WV
Enumeration date
04/19/2007
Last updated
07/21/2022
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