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General NPI Number Information
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NPI Number | 1437158904
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Entity Type | Organization
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Legal Business Name | HOLBROOK NURSING HOME, INC.
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 346 S FLORIDA ST
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City | BUCKHANNON
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State | WV
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Zip | 26201-2452
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Country | US
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Telephone | 304-472-3280
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Fax | 304-472-6805
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Provider Business Mailing Address
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Address Line | 346 S FLORIDA ST
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City | BUCKHANNON
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State | WV
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Zip | 26201-2452
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Country | US
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Telephone | 304-472-3280
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Fax | 304-472-6805
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MRS. HOLLY LAINE HITT
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Credential |
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Telephone | 304-472-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 76
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License Number State | WV
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