Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

1543 Country Club Road Manor Operations LLC

Organization Assisted Living Facility · NPI 1942446745

1543 Country Club Road Manor Operations LLC is an Assisted Living Facility in Fairmont, West Virginia. Licensed in West Virginia. Registered with an NPI since 2008.

Licensed in
WV
In the registry since
2008
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1543 Country Club Rd
Fairmont, WV 26554-1306
Phone: (304) 363-2273
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 506062 (WV)

Record details

NPI number1942446745
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Berg — Secretary · (610) 444-6350
Other names Wishing Well Assisted Living Community At Fairmont Campus
NPI enumeratedDecember 29, 2008
Last updated in NPPESJuly 9, 2025
Certification dateJuly 9, 2025
Mailing address101 E State St, Kennett Square, PA 19348-3109

Other providers in Fairmont