Organization
CRESTVIEW-THS, LLC
Active
Other names
Crestview Manor Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON BONE (VICE-PRESIDENT)
(615) 417-8131
Entity
Organization
Contact information
Practice address
199 COURT ST, JANE LEW, WV 26378-8548
(304) 884-7811
(304) 884-7057
Mailing address
838 CARTHAGE HWY, LEBANON, TN 37087-4611
(615) 417-8131
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
84
WV
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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