| NPI | 1902802259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KONSTANTIN DOLGOVSKIJ Administrator 304-843-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WV 75) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2020-08-22 |