Organization
101 13TH STREET OPERATIONS LLC
Active
Other names
Heritage Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
101 13TH ST, HUNTINGTON, WV 25701-1653
(304) 525-7622
(304) 529-1366
Mailing address
101 13TH ST, HUNTINGTON, WV 25701-1653
(304) 525-7622
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
69
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003692000
—
WV
Enumeration date
12/21/2007
Last updated
05/04/2016
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