| NPI | 1982268405 |
|---|---|
| Doing Business As | MOUNTAIN STATE RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | JOSHUA PRESTON GALBRAITH Owner 304-223-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2020-08-14 |