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Organization

CORTLAND ACRES ASSOCIATION INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BETH A CLEVENGER (ADMINISTRATOR)
(304) 463-4181
Entity
Organization

Contact information

Practice address
39 CORTLAND ACRES LN, THOMAS, WV 26292-8018
(304) 463-4181
(304) 463-4190
Mailing address
39 CORTLAND ACRES LN, THOMAS, WV 26292-8018
(304) 463-4181
(304) 463-4190

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
74
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0003124000
WV
01
001706329
MT. STATE BC BS
WV
05
0158279000
WV
Enumeration date
09/21/2006
Last updated
07/19/2016
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