NPI 1073501466

Wishing Well Manor, INC.

Organisation Assisted Living Facility Fairmont, WV

Practice location

Address: 1543 Country Club Rd, Fairmont, WV 26554-1306
Phone: (304) 366-8414
Fax: (304) 363-2384

Authorised official

Name: Carlene S. Moore
Title: Controller
Phone: (304) 366-8414

Registered specialties (2)

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 132 (WV)

Other Assisted Living Facility providers in West Virginia →

Skilled Nursing Facility

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 59 (WV)

Other Skilled Nursing Facility providers in West Virginia →

Registry record

NPI: 1073501466
Entity type: Organization
NPI issued: 10 Oct 2005
Record last updated: 11 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.