| NPI | 1184288623 |
|---|---|
| Doing Business As | MOUNTAIN STATE RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | JOSHUA PRESTON GALBRAITH Owner 304-223-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2024-03-29 |