Healthcare Provider Details

I. General information

NPI: 1104679091
Provider Name (Legal Business Name): MH SNF OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9945 CENTRAL PARK BLVD N
BOCA RATON FL
33428-1745
US

IV. Provider business mailing address

5679 ROYAL OAK WAY
FORT LAUDERDALE FL
33312-6386
US

V. Phone/Fax

Practice location:
  • Phone: 561-483-0498
  • Fax:
Mailing address:
  • Phone: 917-608-6734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ANDREW BRONFELD
Title or Position: MANAGER
Credential:
Phone: 917-608-6734