# 80 MADDEX DRIVE OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Canterbury Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144404443
- **Authorized official:** MICHAEL BERG (SECRETARY)
- **Authorized official phone:** (610) 444-6350

## Contact information

- **Practice address:** 80 MADDEX DR, SHEPHERDSTOWN, WV 25443-4305
- **Practice address phone:** (304) 876-9422
- **Mailing address:** 101 E STATE ST, KENNETT SQUARE, PA 19348-3109
- **Mailing address phone:** (610) 925-4436
- **Mailing address fax:** (610) 612-5327

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 133 | WV | Yes |

## Other

- **Enumeration date:** 12/21/2007
- **Last updated:** 06/23/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0003509000 | — | WV |