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

Wishing Well Manor, Inc

Organization Assisted Living Facility · NPI 1073501466

Wishing Well Manor, Inc is an Assisted Living Facility in Fairmont, West Virginia. Licensed in West Virginia. Registered with an NPI since 2005.

Licensed in
WV
In the registry since
2005
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1543 Country Club Rd
Fairmont, WV 26554-1306
Phone: (304) 366-8414
Fax: (304) 363-2384
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 132 (WV)
Skilled Nursing Facility Taxonomy 314000000X · Licence 59 (WV)

Record details

NPI number1073501466
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carlene Moore — Controller · (304) 366-8414
Other names Wishing Well Manor
NPI enumeratedOctober 10, 2005
Last updated in NPPESSeptember 11, 2025
Mailing address1543 Country Club Rd, Fairmont, WV 26554-1306

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