Provider Demographics
NPI:1962448829
Name:TEAYS VALLEY HAVEN LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:TEAYS VALLEY HAVEN LIMITED PARTNERSHIP
Other - Org Name:TEAYS VALLEY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:590 POPLAR FORK RD
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9434
Practice Address - Country:US
Practice Address - Phone:304-757-7826
Practice Address - Fax:304-757-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV118314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
001703850OtherMOUTAIN STATE BC/BS
2507243OtherAETNA-HMO
WV0002827000Medicaid
295467OtherUNITED - MAMSI
=========OtherAETNA-NONHMO
WV0002827000Medicaid
=========OtherCARELINK
=========OtherHNFS-TRICARE