Provider Demographics
NPI:1073137923
Name:PLEASANT VALLEY HEALTH CARE CENTER, LLC
Entity Type:Organization
Organization Name:PLEASANT VALLEY HEALTH CARE CENTER, LLC
Other - Org Name:PLEASANT VALLEY NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:304-344-1623
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:CABIN CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:25035-0279
Mailing Address - Country:US
Mailing Address - Phone:304-344-1623
Mailing Address - Fax:304-556-9165
Practice Address - Street 1:640 SANDHILL RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550-2163
Practice Address - Country:US
Practice Address - Phone:304-675-4340
Practice Address - Fax:304-675-6095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility