| NPI | 1063511731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH A CLEVENGER Administrator 304-463-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WV 74) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2016-07-19 |