1543 Country Club Road Manor Operations LLC
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.
Practice location Address checks out
1543 Country Club RdFairmont, WV 26554-1306
Phone: (304) 363-2273
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
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 number | 1942446745 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Michael Berg — Secretary · (610) 444-6350 |
| Other names | Wishing Well Assisted Living Community At Fairmont Campus |
| NPI enumerated | December 29, 2008 |
| Last updated in NPPES | July 9, 2025 |
| Certification date | July 9, 2025 |
| Mailing address | 101 E State St, Kennett Square, PA 19348-3109 |
Other providers in Fairmont
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Wishing Well Manor, Inc
1543 Country Club Rd, Fairmont, WV 26554-1306 · (304) 366-8414