# BRAXTON HEALTH CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043207731
- **Authorized official:** MS. RITA JO DRAZDIK (SECRETARY)
- **Authorized official phone:** (304) 765-2861

## Contact information

- **Practice address:** 859 DAYS DR, SUTTON, WV 26601-6255
- **Practice address phone:** (304) 765-2861
- **Practice address fax:** (304) 765-2863
- **Mailing address:** 859 DAYS DR, SUTTON, WV 26601-6255
- **Mailing address phone:** (304) 765-2861
- **Mailing address fax:** (304) 765-2863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 103 | WV | Yes |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 10/10/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0004097000 | — | WV |