| Logan Mingo Area Mental Health | |
|
174 Lmah Center Rd Logan WV 25601-4058 | |
| (304) 792-7130 | |
| (304) 792-7138 |
| Full Name | Logan Mingo Area Mental Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 174 Lmah Center Rd, Logan, West Virginia |
| Authorized Official Name and Position | Angela Lynn Robertson (BENEFITS COORDINATOR) |
| Authorized Official Contact | 3047927130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Mingo Area Mental Health Po Box 176 Logan WV 25601-0176 Ph: (304) 792-7130 | Logan Mingo Area Mental Health 174 Lmah Center Rd Logan WV 25601-4058 Ph: (304) 792-7130 |
| NPI Number | 1437326832 |
|---|---|
| Provider Enumeration Date | 05/14/2008 |
| Last Update Date | 01/30/2020 |
| Certification Date | 01/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437326832 | NPI | - | NPPES |
| 0005460001 | Medicaid | WV | |
| 0005460000 | Medicaid | WV | |
| 0005460002 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 11 (West Virginia) | Primary |
Southwestern Regional Day Report Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Washington Ave, Suite 300, Logan, WV 25601 Phone: 304-792-8689 Fax: 304-792-2018 | |
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Logan-mingo Area Mental Health, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 174 Lmah Center Rd, Logan, WV 25601 Phone: 304-792-7130 | |
Logan-mingo Area Mental Health, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 174 Lmah Center Rd, Logan, WV 25601 Phone: 304-792-7130 | |
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