Provider Demographics
NPI:1356386726
Name:SISTERSVILLE HAVEN LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:SISTERSVILLE HAVEN LIMITED PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:201 WOOD ST
Practice Address - Street 2:
Practice Address - City:SISTERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26175-1523
Practice Address - Country:US
Practice Address - Phone:304-652-1032
Practice Address - Fax:304-652-2214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV119343900000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
282198OtherUNITED - MAMSI
WV0002847000Medicaid
WV0002847001Medicaid
2507229OtherAETNA-HMO
000329451OtherMOUNTAIN STATE BC/BS
S207OtherHPUOV
=========OtherCIGNA-WV
WV0002847001Medicaid
282198OtherUNITED - MAMSI