Healthcare Provider Details
I. General information
NPI: 1710324413
Provider Name (Legal Business Name): WHITEHALL OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2013
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7300 DEL PRADO CIR S
BOCA RATON FL
33433
US
IV. Provider business mailing address
9020 OVERLOOK BLVD STE 202
BRENTWOOD TN
37027-2755
US
V. Phone/Fax
- Phone: 561-392-3000
- Fax:
- Phone: 615-250-7100
- Fax: 615-250-7101
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
D
ORAND
Title or Position: CEO
Credential:
Phone: 615-250-7100