# FAIRHAVEN OPCO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Madison Park Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295111565
- **Authorized official:** ISAAC S DOLE (MANAGER)
- **Authorized official phone:** (312) 724-8950

## Contact information

- **Practice address:** 700 MADISON AVE, HUNTINGTON, WV 25704-2630
- **Practice address phone:** (304) 522-0032
- **Practice address fax:** (304) 522-1481
- **Mailing address:** 3403 PLEASANT GROVE RD, WHITE HOUSE, TN 37188-5072
- **Mailing address phone:** (561) 301-8661
- **Mailing address fax:** (615) 628-4899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |
| 314000000X | Skilled Nursing Facility | — | NULL | — |

## Other

- **Enumeration date:** 08/10/2015
- **Last updated:** 06/19/2026