MOUNTAINEER RECOVERY CENTER
NPI 1780135863
Substance Abuse Rehabilitation Facility in Kearneysville, WV

NPI Status: Active since October 24, 2016

Contact Information

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

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  • Organization
  • Substance Abuse Rehabilitation Facility
  • Accepts Insurance
  • CLIA Number: 51D2188058
  • CLIA Cert. Type: Other - SUD INPATIENT
  • CLIA Exp. Date: 07-12-2026

About MOUNTAINEER RECOVERY CENTER

This page provides the complete NPI Profile along with additional information for Mountaineer Recovery Center, a provider established in Kearneysville, West Virginia operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1780135863 assigned on October 2016. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Mountaineer Recovery Center. The authorized official of this NPI record is Jason Hendricks (Chief Executive Officer)

NPI
1780135863
Provider Legal Name
MOUNTAINEER BEHAVIORAL HEALTH
Other Organization Name
MOUNTAINEER RECOVERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3094 CHARLES TOWN ROAD KEARNEYSVILLE, WV 25430
Location Phone
(304) 901-2070
Location Fax
(304) 885-1054
Mailing Address
3094 CHARLES TOWN ROAD KEARNEYSVILLE, WV 25430
Mailing Phone
(304) 901-2070
Mailing Fax
(304) 885-1054
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-24-2016
Last Update Date
09-23-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Substance Abuse Rehabilitation Facility

Taxonomy Code
324500000X
Type
Residential Treatment Facilities
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1251S00000XAgencies

Community/Behavioral Health

443 (WV)
2261QR0405XAmbulatory Health Care Facilities

Clinic/Center
Rehabilitation, Substance Use Disorder

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • my Blue Access WV Major Events PPO Catastrophic 9200 - 3 Free PCP Visits - PPO
  • my Blue Access WV PPO Bronze 3800 - PPO
  • my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Bronze 7400 HSA - Custom Drug Benefit - PPO
  • my Blue Access WV PPO Bronze 8900 - PPO
  • my Blue Access WV PPO Gold 0 - PPO
  • my Blue Access WV PPO Gold 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Gold 1700 HSA - PPO
  • my Blue Access WV PPO Premier Gold 0 - PPO
  • my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Silver 7000 - PPO
  • my Blue Access WV PPO Standard Bronze 7500 - PPO
  • my Blue Access WV PPO Standard Gold 1500 - PPO
  • my Blue Access WV PPO Standard Silver 5000 - PPO
  • my Blue Access WV PPO Standard Silver 5000 + Adult Dental and Vision - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JASON HENDRICKS

Authorized Official Title
CHIEF EXECUTIVE OFFICER
Authorized Official Phone
(148) 940-0407

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
443OTHER (01)WVDEPARTMENT OF HEALTH AND HUMAN RESOURCES BEHAVIORAL HEALTH LICENSE

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
51D2188058
Facility Type
Other - SUD INPATIENT
Certificate Effective Date
July 13, 2024
Certificate Expiration Date
July 12, 2026
Laboratory Director
DR. BRADY SCHROER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mountaineer Recovery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for MOUNTAINEER RECOVERY CENTER

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1780135863
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271602310812
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 6 + 0 + 2 + 3 + 1 + 0 + 8 + 1 + 2 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1780135863 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1629613286 BRIAN BARD
Individual
Counselor (Addiction (Substance Use Disorder))3094 CHARLES TOWN ROAD
KEARNEYSVILLE, WV 25430
(304) 991-2070
1922602283 MISTY ELIZABETH GREER-FLOYD
Individual
Counselor (Addiction (Substance Use Disorder))3094 CHARLES TOWN ROAD
KEARNEYSVILLE, WV 25430
(304) 901-2070

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780135863, enumerated in the NPI registry as an "organization" on October 24, 2016

The provider is located at 3094 Charles Town Road Kearneysville, Wv 25430 and the phone number is (304) 901-2070

This medical organization specializes in Substance Abuse Rehabilitation Facility with taxonomy code 324500000X

The provider might be accepting Accepts: Highmark Blue Cross Blue Shield West Virginia,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 51D2188058 for a "other - sud inpatient" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on October 24, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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