Organization
WVDHHR JOHN MANCHIN SR. HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL DIANA MERRILL NHA CEO (ADMINISTRATOR)
(304) 363-2500
Entity
Organization
Contact information
Practice address
401 GUFFEY STREET, FAIRMONT, WV 26554-6554
(304) 363-2500
(304) 363-0263
Mailing address
401 GUFFEY STREET, FAIRMONT, WV 26554-6554
(304) 363-2500
(304) 363-0263
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004092000
—
WV
Enumeration date
11/06/2014
Last updated
11/06/2014
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