590 North Poplar Fork Road Operations LLC
Organization Active NPI Skilled Nursing Facility · Hurricane, WV
NPI 1194909382 · NPPES record last updated Oct 6, 2025
Key facts
- NPI
- 1194909382
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 118 (WV)
- Legal business name
- 590 NORTH POPLAR FORK ROAD OPERATIONS LLC
- Practice address
- 590 Poplar Fork Rd
Hurricane, WV 25526-9434 - Phone
- (304) 757-7826
- Fax
- (304) 757-8861
- NPI assigned
- Dec 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael T Berg
- Title
- Secretary
- Phone
- (610) 444-6350
Owners & managing parties with NPI records 1
Facilities with the same owner 179
Practitioners 1
Affiliated clinicians 3
-
Tasha Bryant, FNP-BC
Medicare Care Compare: Nursing home
- Listed as
- Teays Valley Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 16, 1990
- Medicare certification status
- Active
- Certified beds
- 124 · 119.2 residents per day on average
- Chain
- Genesis Healthcare
- Penalties (3 years)
- 1 · fines totaling $24,948
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Skilled nursing facility certification: CCN 515106
- Legal name
- 590 NORTH POPLAR FORK ROAD OPERATIONS LLC
- Doing business as
- TEAYS VALLEY CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 16, 1990
- Last certification
- Dec 19, 2024
- Beds
- 124
- Ownership / control type
- Corporation
- Multi-facility organization
- Genesis
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 16, 2007 in WV
- Enrollment address
- 1390 N Poplar Fork Rd
Hurricane, WV 25526-7112 - Nursing home name
- TEAYS VALLEY CENTER
- Affiliated entity
- GENESIS HEALTHCARE
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Laura Bridgeford |
Corporate Officer |
Jun 1, 2024 | |
| HCCF Management Group XI LLC |
5% Or Greater Indirect Ownership Interest | Nov 15, 2022 | 10.8% |
| Gen Operations I LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Gen Operations II LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Genesis WV Holdings LLC |
5% Or Greater Direct Ownership Interest | Apr 1, 2011 | 100% |
| Jeffrey Scott Holmes |
Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Mar 23, 2025 | ||
| FC-Gen Operations Investment LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Genesis Operations LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| |
Adp of the SNF | Mar 23, 2025 | |
| Sundance Rehabilitation Holdco Inc |
5% Or Greater Indirect Ownership Interest | Nov 15, 2022 | 5.2% |
| |
Adp of the SNF | Mar 23, 2025 | |
| Genesis Healthcare LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Sun Healthcare Group Inc |
5% Or Greater Indirect Ownership Interest | Nov 15, 2022 | 65.3% |
| Cassidy Duffer |
Operational/Managerial Control | Jun 1, 2024 | |
| Adp of the SNF | Mar 23, 2025 | ||
| Arnold M Whitman |
5% Or Greater Indirect Ownership Interest |
Nov 15, 2022 | 10.8% |
| Genesis Healthcare Inc |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Zac Properties XI LLC |
5% Or Greater Indirect Ownership Interest | Nov 15, 2022 | 7.6% |
| Steven E Fishman |
5% Or Greater Indirect Ownership Interest |
Nov 15, 2022 | 7.6% |
| |
Adp of the SNF | Mar 23, 2025 | |
| Avi Pinchas Mendelson |
Corporate Officer |
Jun 1, 2024 | |
| Michael T Berg |
Corporate Officer |
Dec 1, 2012 | |
| Welltower Inc |
5% Or Greater Indirect Ownership Interest | Nov 15, 2022 | 5.7% |
| GHC Holdings LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Genesis Holdings LLC |
5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080411000092 | WV | Part a Provider - Skilled Nursing Facility | 2062599277 | Practice locations: Hurricane, WV |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 118 | WV | Yes |
Addresses
Primary practice location
590 Poplar Fork Rd
Hurricane, WV 25526-9434
Mailing address
101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002827000 | Medicaid | WV |
Other names
- Teays Valley Center
Other providers in Hurricane, WV
- 300 Seville Court Opco, LLC
- 304 Primary Care
- A Helping Hand, LLC
- Robin Acey
- Active Medical LLC
- Madeline Zenia Adams
- Mary Hunter Adams
All providers in Hurricane, WV · Skilled Nursing Facility in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.