Organization · Type 2 NPI

1543 Country Club Road Manor Operations LLC

Assisted Living Facility · Fairmont, WV

NPI number 1942446745 Active

Practice location

1543 Country Club Rd
Fairmont, WV 26554-1306

Mailing address

101 E State St
Kennett Square, PA 19348-3109

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000X506062 (WV)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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About NPI 1942446745

1543 Country Club Road Manor Operations LLC's National Provider Identifier is 1942446745, issued on Dec 29, 2008. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Fairmont, WV. The record was last updated on Jul 9, 2025.