# KINGWOOD CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PineRidge, Stonerise Kingwood
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902281041
- **Authorized official:** MR. LAWRENCE A PACK (MANAGER)
- **Authorized official phone:** (304) 343-1950

## Contact information

- **Practice address:** 300 MILLER RD, KINGWOOD, WV 26537-1335
- **Practice address phone:** (304) 329-3195
- **Practice address fax:** (304) 329-0246
- **Mailing address:** 700 CHAPPELL RD, CHARLESTON, WV 25304-2704
- **Mailing address phone:** (304) 343-1950
- **Mailing address fax:** (304) 343-1947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 96 | WV | — |
| 314000000X | Skilled Nursing Facility | 96 | WV | Yes |

## Other

- **Enumeration date:** 07/29/2015
- **Last updated:** 05/18/2022