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Organization
EASTBROOK CENTER LLC
Active
Organization
EASTBROOK CENTER LLC
Active
Other names
Stonerise Charleston
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE A PACK (OWNER/MANAGER)
(304) 343-1950
Entity
Organization
Contact information
Practice address
3819 CHESTERFIELD AVE, CHARLESTON, WV 25304-2647
(304) 925-4771
(304) 925-1343
Mailing address
700 CHAPPELL RD, CHARLESTON, WV 25304-2704
(304) 343-1950
(304) 343-1947
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
65
WV
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Enumeration date
08/20/2013
Last updated
05/18/2022
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