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1C

1543 COUNTRY CLUB ROAD MANOR OPERATIONS LLC

Skilled Nursing Facility

OIG CLEARNPI VERIFIED
Location
FAIRMONT, WV
Licensed since
2008
Rate
Federal identifiers
NPI registry number1396981064
Agency details
Medicare activity
StatusNo Medicare utilization on file — neutral.
Authorized official
NameMICHAEL BERG
TitleSECRETARY
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