| NPI | 1780135863 |
|---|---|
| Doing Business As | MOUNTAINEER RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | JASON HENDRICKS Chief Executive Officer 148-940-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X (Licence: WV 443) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2024-09-23 |