- Enrollment id
- O20211103002744
- Enrollment state
- WV
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1801470463
- Multiple npi flag
- N
- Ccn
- 515163
- Associate id
- 1850794504
- Organization name
- COMPLETE CARE AT DAWNVIEW LLC
- Doing business as name
- COMPLETE CARE AT DAWNVIEW LLC
- Incorporation date
- 2021-03-10
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- COMPLETE CARE AT DAWNVIEW LLC
- Affiliation entity name
- COMPLETE CARE
- Affiliation entity id
- 157
- Address line 1
- 1 DIANE DR
- City
- FORT ASHBY
- State
- WV
- Zip code
- 26719