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Organization
BROADDUS HOSPITAL ASSOCIATION, INC.
Active
Organization
BROADDUS HOSPITAL ASSOCIATION, INC.
Active
Other names
Mansfield Place
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA L. GOULD (CEO)
(304) 457-1760
Entity
Organization
Contact information
Practice address
#5 HEALTHCARE DRIVE, MANSFIELD HILL, PHILIPPI, WV 26416
(304) 457-8535
(304) 457-1516
Mailing address
#5 HEALTHCARE DRIVE, P.O. BOX 930, PHILIPPI, WV 26416
(304) 457-8535
(304) 457-1516
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
96
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002167001
—
WV
Enumeration date
12/08/2006
Last updated
07/09/2019
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