# KAUFMAN STREET WV LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Arbors at Fairmont
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346274370
- **Authorized official:** MS. DONNA J MAASSEN (PRIVACY OFFICER)
- **Authorized official phone:** (414) 908-8119

## Contact information

- **Practice address:** 130 KAUFMAN DR, FAIRMONT, WV 26554-2179
- **Practice address phone:** (304) 363-5633
- **Mailing address:** 111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
- **Mailing address phone:** (414) 908-8119
- **Mailing address fax:** (414) 908-7105

## Taxonomy

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

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 03/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0004212000 | — | WV |