| NPI | 1003813510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R. EIDELL Administrator/President 304-636-1008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WV 51) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2020-08-22 |