Organization
GRAYSON ASSISTED LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN DWAYNE GRAYSON (VICE PRESIDENT)
(304) 417-4969
Entity
Organization
Contact information
Practice address
25 OLD TRL, 3455 ST RT 75, HUNTINGTON, WV 25704-9281
(304) 972-0815
(304) 972-0814
Mailing address
25 OLD TRAIL, 3455 ST RT 75, HUNTINGTON, WV 25704
(304) 972-0815
(304) 972-0814
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
507554
WV
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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