Organization
NEW RIVERRANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA TORRES REVEREND (DIRECTOR)
(304) 574-1058
Entity
Organization
Contact information
Practice address
PO BOX 178, FAYETTEVILLE, WV 25840-0178
(304) 574-1058
(304) 574-3724
Mailing address
PO BOX 178, FAYETTEVILLE, WV 25840-0178
(304) 574-1058
(304) 574-3427
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
1040-2523
WV
Other
Enumeration date
05/24/2017
Last updated
05/24/2017
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