Council of the Southern Mountains
NPI #1881716611 in Keystone, West Virginia
Provider Information
- NPI Number
- 1881716611
- Entity Type
- Organization
- Organization Name
- Council of the Southern Mountains
- Primary Specialty
- Day Training, Developmentally Disabled Services
- Enumeration Date
- Apr 4, 2007
- Last Updated
- Aug 13, 2008
Practice Location
- Address
- 69 MAIN ST.
- Address 2
- OLD KEYSTONE BANK BUILDING
- City
- Keystone
- State
- West Virginia
- ZIP Code
- 24868-0085
- Phone
- (304) 862-3144
Authorized Official
- Name
- MR. RANDAL JOHNSON, M.A.
- Title
- EXECUTIVE DIRECTOR
- Phone
- (304) 862-3144
Specialties & Taxonomy Codes
| Specialty |
|---|
| Day Training, Developmentally Disabled Services |
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