FAIRHAVEN OPCO, LLC (NPI# 1295111565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295111565 |
| Entity Type | Organization |
| Organization Name | FAIRHAVEN OPCO, LLC |
| Other Organization Name | MADISON PARK HEALTHCARE |
| Practice Address |
700 Madison Ave Huntington WV 25704-2630 |
| Mailing Address |
121 S Water Ave Gallatin TN 37066-2902 |
| Practice Telephone | 3045520032 |
| Practice Fax Number | 3045221481 |
| Mailing Telephone | 4232902837 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-12-12 |
| Authorized Official Name | ISAAC S DOLE (MANAGER) |
| Authorized Official Telephone | 3127248950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities | ||
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Madison Park Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194180489 | Fairhaven Opco, LLC | Occupational Therapist | 700 Madison Ave, Huntington, WV 25704-2630 | 2015-12-31 |
| Street Address |
700 MADISON AVE |
| City | HUNTINGTON |
| State | WV |
| Zip Code | 25704-2630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962594630 | Fairhaven Rest Home, Inc | Skilled Nursing Facility | 700 Madison Ave, Huntington, WV 25704-2630 | 2006-09-29 |
| 1265890610 | Adam Forrest | Occupational Therapist | 700 Madison Ave, Huntington, WV 25704-2630 | 2016-01-31 |
| 1194180489 | Fairhaven Opco, LLC | Occupational Therapist | 700 Madison Ave, Huntington, WV 25704-2630 | 2015-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497354161 | Sherry Jean Short | Technician | 315 1/2 W 13th Street, Huntington, WV 25704 | 2020-10-22 |
| 1063029940 | Kathern Sullivan | Technician | 2950 Apt. B1 Auburn Rd, Huntington, WV 25704 | 2020-09-25 |
| 1932713229 | John Webb | Technician | 3717 Lot 17 Rte. 75, Huntington, WV 25704 | 2020-09-03 |
| 1679114458 | Betty Bentley | Technician | 1588 Spring Valley Drive, Huntington, WV 25704 | 2019-10-03 |
| 1568948958 | Jessica E Hall | Assistant Behavior Analyst | 4614 Waverly Road, Huntington, WV 25704 | 2018-07-18 |
| 1538662457 | Abayomi Adeyi | Nurse Practitioner | Huntington Va Medical Center 1540 Spring Valley Drive, Huntington, WV 25704 | 2018-03-16 |
| 1851807242 | Shirley Meldave Ross | Technician | 1591 Buffalo Creek Road, Huntington, WV 25704 | 2017-12-20 |
| 1245772045 | Emily Marie Miller | Massage Therapist | 3637 Hughes St, Huntington, WV 25704 | 2016-11-09 |
| 1265785737 | William M Jennings IIi | Internal Medicine | 1448 10th Avenue, Suite 100, Huntington, WV 25704 | 2012-10-22 |
| 1477709921 | Huntington Va Medical Center | General Acute Care Hospital | 540 Spring Valley Dr, Huntington, WV 25704 | 2008-08-15 |
| Find all providers in zip 25704 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556546 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 1180 W 500 N, Huntington, IN 46750-1661 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336524586 | Bridgeport Health Care Center, LLC | Nursing Facility/Intermediate Care Facility | Rt 4 Box 17, Bridgeport, WV 26330-9509 | 2015-07-29 |
| 1629453766 | Rainelle Center LLC | Nursing Facility/Intermediate Care Facility | 276 Pennsylvania Ave, Rainelle, WV 25962-1177 | 2015-07-29 |
| 1558754507 | Lewisburg Center LLC | Nursing Facility/Intermediate Care Facility | 979 Rocky Hill Rd, Ronceverte, WV 24970-8028 | 2015-03-16 |
| 1467845412 | Wellsburg Center LLC | Nursing Facility/Intermediate Care Facility | 70 Valley Haven Dr, Wellsburg, WV 26070-2625 | 2015-03-16 |
| 1508254319 | Mary Bird | Nursing Facility/Intermediate Care Facility | 590 North Poplar Fork Rd, Hurricane, WV 25526-9434 | 2014-12-31 |
| 1952536377 | Springfield Center LLC | Nursing Facility/Intermediate Care Facility | 10797 Seneca Trl S, Lindside, WV 24951-7345 | 2009-05-29 |
| 1720281975 | Pleasant Valley Nursing and Rehabilitation Center, Inc. | Nursing Facility/Intermediate Care Facility | 640 Sandhill Rd, Pt Pleasant, WV 25550-2163 | 2007-06-06 |
| 1255427415 | Bridgeport Senior Living, LLC | Nursing Facility/Intermediate Care Facility | Rr 4 Box 17, Bridgeport, WV 26330-9509 | 2006-10-05 |
| 1194816025 | Lakin Hospital | Nursing Facility/Intermediate Care Facility | 1 Bateman Cir, Lakin, WV 25287-9784 | 2006-09-27 |
| 1922100031 | Morgantown Healthcare Corp | Nursing Facility/Intermediate Care Facility | 30 Vandervort Dr, Morgantown, WV 26505 | 2006-09-01 |
| Find all providers with the same taxonomy | ||||
| City | HUNTINGTON |
| Zip Code | 25704 |
Please comment or provide details below to improve the information on FAIRHAVEN OPCO, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.