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Organization
WISHING WELL NURSING HOME, INC.
Active
Organization
WISHING WELL NURSING HOME, INC.
Active
Other names
WISHING WELL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLENE S. MOORE NHA (CONTROLLER)
(304) 366-8414
Entity
Organization
Contact information
Practice address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 366-8414
(304) 363-2384
Mailing address
1539 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 366-8414
(304) 363-2384
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
62
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003887000
—
WV
Enumeration date
10/10/2005
Last updated
08/22/2020
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