New Riverranch

Organization Active NPI Assisted Living Facility (Behavioral Disturbances) · Fayetteville, WV

NPI 1639607484 · NPPES record last updated May 24, 2017

Key facts

NPI
1639607484
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility (Behavioral Disturbances) 3104A0630X
License
1040-2523 (WV)
Legal business name
NEW RIVERRANCH
Practice address
PO Box 178
Fayetteville, WV 25840-0178
Phone
(304) 574-1058
Fax
(304) 574-3724
NPI assigned
May 24, 2017
Organization subpart
No

Authorized official

Name
Carla Torres, REVEREND
Title
Director
Phone
(304) 574-1058

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
New River Ranch Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X 1040-2523 WV Yes

Addresses

Primary practice location

PO Box 178
Fayetteville, WV 25840-0178

Mailing address

PO Box 178
Fayetteville, WV 25840-0178
Phone (304) 574-1058

Other providers in Fayetteville, WV

All providers in Fayetteville, WV · Assisted Living Facility (Behavioral Disturbances) in West Virginia

Sources for this page

Verify at the official NPI Registry.