Organization · Type 2 NPI

1543 Country Club Road Manor Operations LLC

Skilled Nursing Facility · Fairmont, WV

NPI number 1396981064 Active

Practice location

1543 Country Club Rd
Fairmont, WV 26554-1306

Call (304) 363-2273 Map

Mailing address

101 E State St
Kennett Square, PA 19348-3109

Specialties and licenses

TaxonomyCodeLicense
Skilled Nursing Facility Primary 314000000X59 (WV)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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About NPI 1396981064

1543 Country Club Road Manor Operations LLC's National Provider Identifier is 1396981064, issued on Dec 30, 2008. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Fairmont, WV. The record was last updated on Jul 9, 2025.