Organization
FAYETTE NURSING & REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD JONES (EXECUTIVE VICE PRESIDENT)
(304) 344-1623
Entity
Organization
Contact information
Practice address
100 HRESAN BLVD, FAYETTEVILLE, WV 25840-1333
(304) 574-0770
(304) 574-1434
Mailing address
100 HRESAN BLVD, FAYETTEVILLE, WV 25840-1333
(304) 574-0770
(304) 574-1434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
48
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003077000
—
WV
Enumeration date
12/28/2006
Last updated
11/19/2009
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