Organization
KINGWOOD CENTER LLC
Active
Other names
PineRidge, Stonerise Kingwood
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE A PACK (MANAGER)
(304) 343-1950
Entity
Organization
Contact information
Practice address
300 MILLER RD, KINGWOOD, WV 26537-1335
(304) 329-3195
(304) 329-0246
Mailing address
700 CHAPPELL RD, CHARLESTON, WV 25304-2704
(304) 343-1950
(304) 343-1947
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
96
WV
314000000X
Skilled Nursing Facility
Primary
96
WV
Other
Enumeration date
07/29/2015
Last updated
05/18/2022
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