| NPI | 1023362183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA KELLY TARVER Cota 304-989-7074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WV C1601) |
| Enumeration Date | 2012-10-28 |
| Last Update Date | 2012-10-28 |