Organization Active NPI

Valley Haven Geriatric Center Inc

  • Skilled Nursing Facility
  • Wellsburg, WV
National Provider Identifier
1164410775
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
113 Issued in WV
Legal business name
VALLEY HAVEN GERIATRIC CENTER INC
Practice address
Rd#2 Box 44
Wellsburg, WV 26070-9505
Phone
(304) 394-5322
Fax
(304) 394-1242
NPI assigned
Oct 7, 2005
Organization subpart
Yes
Parent organization
VALLEY HAVEN GERIATRIC CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael L Anderson
Title
President-Administrator
Phone
(304) 394-5322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 113 WV Primary

Addresses

Primary practice location

Rd#2 Box 44
Wellsburg, WV 26070-9505

Mailing address

Rd#2 Box 44
Wellsburg, WV 26070-9505
Phone (304) 394-5322

Other identifiers 1

IdentifierTypeStateIssuer
0003883000MedicaidWV

National Provider Directory

National Provider Directory
Part of
Valley Haven Geriatric Center Inc

Locations

70 Valley Haven Dr
Wellsburg, WV 26070
Phone (304) 394-5322

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1164410775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RD#2 BOX 44",
            "city": "WELLSBURG",
            "state": "WV",
            "postal_code": "260709505",
            "telephone_number": "304-394-5322",
            "fax_number": "304-394-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RD#2 BOX 44",
            "city": "WELLSBURG",
            "state": "WV",
            "postal_code": "260709505",
            "telephone_number": "304-394-5322",
            "fax_number": "304-394-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY HAVEN GERIATRIC CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VALLEY HAVEN GERIATRIC CENTER INC",
        "enumeration_date": "2005-10-07",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT-ADMINISTRATOR",
        "authorized_official_telephone_number": "304-394-5322",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003883000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.