MOUNTAINEER BEHAVIORAL HEALTH NPI 1780135863

NPI Information

NPI: 1780135863
Provider Name: MOUNTAINEER BEHAVIORAL HEALTH
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Doing Business As: MOUNTAINEER RECOVERY CENTER
CLIA Number: 51D2188058
Address: 3094 CHARLES TOWN ROAD
KEARNEYSVILLE, WV
ZIP 25430
Phone: (304) 901-2070

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NPI Details

MOUNTAINEER BEHAVIORAL HEALTH is a substance abuse rehabilitation facility in Kearneysville, WV. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. MOUNTAINEER BEHAVIORAL HEALTH NPI is 1780135863. The provider is registered as an organization entity type.
The provider Is Doing Business As Mountaineer Recovery Center.

The provider's business location address is:

3094 CHARLES TOWN ROAD
KEARNEYSVILLE, WV
ZIP 25430
Phone: (304) 901-2070
Fax: (304) 885-1054

The provider's authorized official is Jason Hendricks .
The authorized official title is Chief Executive Officer and has the following contact phone number (148) 940-0407.

The CLIA number assigned to this NPI record is 51D2188058 - other - sud inpatient with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/24/2016 and was last updated on 9/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251S00000X	Community/Behavioral Health		443	WEST VIRGINIA	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
3	324500000X	Substance Abuse Rehabilitation Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	443	OTHER	WEST VIRGINIA	DEPARTMENT OF HEALTH AND HUMAN RESOURCES BEHAVIORAL HEALTH LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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