Organization
SEVENTEENTH STREET ASSOCIATES LLC
Active
Other names
Huntington Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS P. SIMONS (SENIOR VP OPERATIONS FINANCE)
(770) 829-5100
Entity
Organization
Contact information
Practice address
1720-17TH STREET, HUNTINGTON, WV 25701-4235
(304) 529-6031
(304) 525-3954
Mailing address
5300 W SAM HOUSTON PKWY N, SUITE 100, HOUSTON, TX 77041-5161
(832) 467-6000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
8
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002926000
—
WV
01
—
150028WVA
PREVIOUS MEDICAID NUMBER
WV
Enumeration date
06/14/2006
Last updated
11/11/2020
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