Organization
HQM OF CHARLESTOWN, LLC
Active
Other names
Blue Ridge Care & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL WALCZAK (CEO)
(561) 627-0664
Entity
Organization
Contact information
Practice address
1263 S GEORGE ST, CHARLES TOWN, WV 25414-4384
(304) 725-6575
Mailing address
1263 S GEORGE ST, CHARLES TOWN, WV 25414-4384
(304) 725-6575
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001000-000
—
WV
Enumeration date
07/08/2006
Last updated
08/22/2020
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