# GLENWOOD PARK, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GlenWood Park Retirement Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205824646
- **Authorized official:** MR. DANIEL W. FARLEY CNHA (CEO / PRESIDENT / ADMINISTRATOR)
- **Authorized official phone:** (304) 425-8128

## Contact information

- **Practice address:** 1924 GLENWOOD PARK RD, PRINCETON, WV 24740-7969
- **Practice address phone:** (304) 425-8128
- **Practice address fax:** (304) 487-1338
- **Mailing address:** 1924 GLENWOOD PARK RD, PRINCETON, WV 24740-7969
- **Mailing address phone:** (304) 425-8128
- **Mailing address fax:** (304) 487-1338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 4 | WV | Yes |

## Other

- **Enumeration date:** 10/10/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0003502000 | — | WV |