Provider Demographics
NPI:1790701324
Name:MOUNTAIN AREA COMMUNITY SERVICES
Entity Type:Organization
Organization Name:MOUNTAIN AREA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ARLEN
Authorized Official - Last Name:LUTHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-659-1180
Mailing Address - Street 1:366 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-4527
Mailing Address - Country:US
Mailing Address - Phone:828-659-1180
Mailing Address - Fax:828-659-1182
Practice Address - Street 1:366 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-4527
Practice Address - Country:US
Practice Address - Phone:828-659-1180
Practice Address - Fax:828-659-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408900Medicaid