Wishing Well Manor

LBN: Wishing Well Manor, Inc.
Wishing Well Manor is an health care organization with primary practice located at 1543 Country Club Rd , Fairmont WV 26554-1306. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty. Wishing Well Manor, Inc. can be contacted via phone (304) 366-8414, or through Moore, Carlene S. via phone (304) 366-8414.

Contact Information

Primary practice address
1543 Country Club Rd Fairmont WV 26554-1306
Phone: (304) 366-8414
Fax: (304) 363-2384
Website:
Map and Directions
Authorized official contact:
Name: Moore, Carlene S. NHA
Phone: (304) 366-8414

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 132 West Virginia
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 59 West Virginia

Profile Details

NPI number 1073501466
LBN Legal business name Wishing Well Manor, Inc.
DBA Doing business as Wishing Well Manor
Authorized official Moore, Carlene S. NHA
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2005
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073501466 NPPES
West Virginia MEDICAID 0003893000

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