| NPI | 1740309160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA DELOE Office Manager 304-846-2573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WV 128) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |