- Enrollment id
- O20240228003800
- Enrollment state
- WV
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1073227104
- Multiple npi flag
- N
- Ccn
- 515164
- Associate id
- 0345685459
- Organization name
- WARRIOR LEASING CO LLC
- Doing business as name
- WYOMING HEALTHCARE CENTER
- Incorporation date
- 2022-10-14
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- WYOMING HEALTHCARE CENTER
- Affiliation entity name
- COMMUNICARE HEALTH
- Affiliation entity id
- 153
- Address line 1
- 236 WARRIOR WAY
- City
- NEW RICHMOND
- State
- WV
- Zip code
- 248670149