WISHING WELL MANOR, INC.
NPI 1073501466
Assisted Living Facility in Fairmont, WV

Q: What is Wishing Well Manor, Inc.'s NPI number?

The NPI number for Wishing Well Manor, Inc. is 1073501466. It was assigned to this organization in the NPPES registry on October 10, 2005. The provider is doing business as Wishing Well Manor.

Q: What is Wishing Well Manor, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since October 10, 2005

1543 COUNTRY CLUB RD, FAIRMONT, WV 26554(304) 366-8414(304) 363-2384 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About Wishing Well Manor, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WISHING WELL MANOR, INC. (NPI 1073501466), doing business as Wishing Well Manor, is a healthcare organization registered as an assisted living facility in Fairmont, West Virginia and active in the NPI registry since October 2005. The organization lists Carlene S. Moore, Controller, as its authorized official.

NPPES Registry Identity

NPI1073501466

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameWISHING WELL MANOR, INC.

Location Address1543 COUNTRY CLUB RDFairmont, WV 26554-1306

Mailing Address1543 Country Club RdFairmont, WV 26554-1306 · (304) 366-8414 · Fax (304) 363-2384

Phone(304) 366-8414

Fax(304) 363-2384

Organization SubpartNo

Authorized OfficialCarlene S. MooreController · (304) 366-8414

Enumeration DateOctober 10, 2005

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1073501466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in WV · 132

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Also ListedSkilled Nursing FacilityTaxonomy 314000000X · License 59 (WV)

1543 COUNTRY CLUB RD, Fairmont, WV 26554

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Other Names 1

Doing Business AsWishing Well Manor

Other Identifiers 1

Medicaid0003893000WV

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALIGNMED MEDICAL GROUP WV, PC

Internal Medicine (Geriatric Medicine)