# FAYETTEVILLE SNF LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fayetteville Rehabilitation and Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043131790
- **Authorized official:** ROBERT COHEN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (347) 463-2399

## Contact information

- **Practice address:** 100 HRESAN BLVD, FAYETTEVILLE, WV 25840-1333
- **Practice address phone:** (304) 574-0770
- **Mailing address:** 100 HRESAN BLVD, FAYETTEVILLE, WV 25840-1333
- **Mailing address phone:** (304) 574-0770

## Taxonomy

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

## Other

- **Enumeration date:** 07/21/2026
- **Last updated:** 07/21/2026