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Contact Information

FAYETTE NURSING & REHABILITATION CENTER LLC
100 HRESAN BLVD
FAYETTEVILLE, WV25840-1333
 Phone: 304-574-0770
 Fax: 304-574-1434
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for FAYETTE NURSING & REHABILITATION CENTER LLC

NPI # 1871659730
LBN Legal business name FAYETTE NURSING & REHABILITATION CENTER LLC
Authorized official TODD JONES - (EXECUTIVE VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2006
Last updated 11/19/2009 - About 17 years ago
Identifiers
WV License # 48
WV Medicaid 0003077000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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