Organization
1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC
Active
Other names
Wishing Well Assisted Living Community at Fairmont Campus
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T BERG (SECRETARY)
(610) 444-6350
Entity
Organization
Contact information
Practice address
1543 COUNTRY CLUB RD, FAIRMONT, WV 26554-1306
(304) 363-2273
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 347-4099
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
506062
WV
Other
Enumeration date
12/29/2008
Last updated
07/09/2025
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