# FAYETTE COMMUNITY HEALTH CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hidden Valley Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720081615
- **Authorized official:** MR. CALVIN L SUTPHIN II NHA (ADMINISTRATOR)
- **Authorized official phone:** (304) 465-1903

## Contact information

- **Practice address:** 422 23RD ST, OAK HILL, WV 25901-2830
- **Practice address phone:** (304) 465-1903
- **Practice address fax:** (304) 949-3807
- **Mailing address:** 422 23RD ST, OAK HILL, WV 25901-2830
- **Mailing address phone:** (304) 465-1903
- **Mailing address fax:** (304) 949-3807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 129 | WV | Yes |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0003674000 | — | WV |