| NPI | 1194294587 |
|---|---|
| Doing Business As | MOUNTAIN STATE RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | JOSEPH SHAFFER COO 859-489-2705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2024-03-15 |