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Organization

1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC

Active
Other names
Pierpont Center at Fairmont Campus
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL T BERG (SECRETARY)
(610) 444-6350
Entity
Organization

Contact information

Practice address
1543 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 363-2273
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 347-4099

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
59
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810013993
WV
Enumeration date
12/30/2008
Last updated
07/09/2025
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