| NPI | 1720081615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN L SUTPHIN Administrator 304-465-1903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WV 129) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2020-08-22 |