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General NPI Number Information
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NPI Number | 1558754507
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Entity Type | Organization
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Legal Business Name | LEWISBURG CENTER LLC
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Dates
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Enumeration Date | 03/16/2015
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 979 ROCKY HILL RD
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City | RONCEVERTE
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State | WV
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Zip | 24970-8028
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Country | US
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Telephone | 304-645-7270
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Fax | 304-645-6522
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Provider Business Mailing Address
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Address Line | 700 CHAPPELL RD
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City | CHARLESTON
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State | WV
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Zip | 25304-2704
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Country | US
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Telephone | 304-343-1950
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Fax | 304-343-1947
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Authorized Official
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Title or Position | MANAGER
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Name | STEVEN F WHITE
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Credential |
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Telephone | 304-343-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 80
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 80
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License Number State | WV
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