# WILLOW TREE MANOR - UHA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033348883
- **Legal business name:** WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
- **Authorized official:** ROBYN M MCDANIEL (PROVIDER RELATIONS SUPERVISOR)
- **Authorized official phone:** (304) 293-5033

## Contact information

- **Practice address:** 1263 S GEORGE ST, CHARLES TOWN, WV 25414-4384
- **Practice address phone:** (304) 725-6575
- **Mailing address:** PO BOX 780, MORGANTOWN, WV 26507-0780
- **Mailing address phone:** (304) 293-7401
- **Mailing address fax:** (304) 293-6963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 07/14/2009
- **Last updated:** 07/14/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0011526000 | — | WV |