Organization
MEADOWVIEW MANOR HEALTH CARE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACI L HENDERSON (CEO/ OWNER)
(304) 842-7101
Entity
Organization
Contact information
Practice address
41 CRESTVIEW TER, BRIDGEPORT, WV 26330-1010
(304) 842-7101
(304) 842-7104
Mailing address
41 CRESTVIEW TER, BRIDGEPORT, WV 26330-1010
(304) 842-7101
(304) 842-7104
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
104
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004114000
—
WV
Enumeration date
07/18/2005
Last updated
11/04/2011
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