1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC NPI 1942446745

NPI Information

1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC is an assisted living facility in Fairmont, WV. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. 1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC NPI is 1942446745. The provider is registered as an organization entity type.
The provider Is Doing Business As Wishing Well Assisted Living Community At Fairmont Campus.

The provider's business location address is:

1543 COUNTRY CLUB RD
FAIRMONT, WV
ZIP 26554-306
Phone: (304) 363-2273

The provider's authorized official is Jane Dropeskey .
The authorized official title is Corporate Manager and has the following contact phone number (610) 925-4231.

The enumeration date for this NPI number is 12/29/2008 and was last updated on 11/16/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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