| NPI | 1780682088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHASTA L. HYSON Administrator 304-636-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WV 17) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2007-07-13 |