SHENANDOAH MANOR, INC
Nursing Care, Pediatric
Ronceverte, West Virginia
Provider NPI: 1093702979
Organization Information:Organization Name: SHENANDOAH MANOR, INC
Practice Location:
601 ROCKY HILL RD RONCEVERTE, WV 24970 US
Tel: 304-645-7270 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
601 ROCKY HILL RD RONCEVERTE, WV 24970 US
Tel: 304-645-7270 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3140N1450X | Nursing & Custodial Care Facilities Skilled Nursing Facility Nursing Care, Pediatric | WV | 80 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0004165000 | WV | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin