200 South Ritchie Avenue Operations LLC
NPI #1124202304 in Ravenswood, West Virginia
Provider Information
- NPI Number
- 1124202304
- Entity Type
- Organization
- Organization Name
- 200 South Ritchie Avenue Operations LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Dec 24, 2007
- Last Updated
- May 2, 2016
Practice Location
- Address
- 200 S RITCHIE AVE
- City
- Ravenswood
- State
- West Virginia
- ZIP Code
- 26164-1721
- Phone
- (304) 273-9385
Authorized Official
- Name
- MICHAEL T. BERG
- Title
- ASSISTANT SECRETARY
- Phone
- (505) 468-4752
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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