Organization
FAIRHAVEN REST HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA P. MCCALL (ADMINISTRATOR)
(304) 522-0032
Entity
Organization
Contact information
Practice address
700 MADISON AVE, HUNTINGTON, WV 25704-2630
(304) 522-0032
(304) 522-1481
Mailing address
700 MADISON AVE, P. O. BOX 2806, HUNTINGTON, WV 25704-2630
(304) 522-0032
(304) 522-1481
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003341000
—
WV
Enumeration date
09/29/2006
Last updated
09/23/2014
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