GLENWOOD PARK, INC.
NPI 1205824646
Skilled Nursing Facility in Princeton, WV

Active since October 10, 2005CLIA 51D0710485 · Waiver
1924 GLENWOOD PARK RD, PRINCETON, WV 24740(304) 425-8128(304) 487-1338 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Glenwood Park, Inc. NPPES

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

GLENWOOD PARK, INC. (NPI 1205824646), doing business as Glenwood Park Retirement Village, is a healthcare organization registered as a skilled nursing facility in Princeton, West Virginia and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Daniel W. Farley, Ceo / President / Administrator, as its authorized official.

NPPES Registry Identity

NPI1205824646
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGLENWOOD PARK, INC.
Location Address1924 GLENWOOD PARK RDPrinceton, WV 24740-7969
Mailing Address1924 Glenwood Park RdPrinceton, WV 24740-7969 · (304) 425-8128 · Fax (304) 487-1338
Fax(304) 487-1338
Organization SubpartNo
Authorized OfficialDaniel W. FarleyCeo / President / Administrator · (304) 425-8128
Enumeration DateOctober 10, 2005
Last NPPES UpdateAugust 22, 2020
NPI 1205824646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in WV · 4
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

1924 GLENWOOD PARK RD, Princeton, WV 24740

Other Names 1

Former Legal Business NameGlenwood Park Retirement Village

Other Identifiers 1

Medicaid0003502000WV

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D0710485

Glenwood Park Leasing Co, LLC · Princeton, WV
Active · expires Aug 31, 2026
CLIA Number51D0710485
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. Kristin Bowman
Laboratory Phone(304) 425-8128
Laboratory LocationGlenwood Park Leasing Co, LLC1924 Glenwood Park Road, Princeton, WV 24739
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenwood Park, Inc.'s NPI number?

The NPI number for Glenwood Park, Inc. is 1205824646. It was assigned to this organization in the NPPES registry on October 10, 2005. The provider was formerly known as Glenwood Park Retirement Village.

Where is Glenwood Park, Inc. located?

Glenwood Park, Inc. is located at 1924 Glenwood Park Rd, Princeton, WV 24740. The listed phone number is (304) 425-8128.

What is Glenwood Park, Inc.'s specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Glenwood Park, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 51D0710485) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Glenwood Park, Inc. was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.