Healthcare Provider Details

I. General information

NPI: 1962327874
Provider Name (Legal Business Name): DELAND ATHENS OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 W EUCLID AVE
DELAND FL
32720-6771
US

IV. Provider business mailing address

31 BROOKFALL RD
EDISON NJ
08817-2946
US

V. Phone/Fax

Practice location:
  • Phone: 386-734-9085
  • Fax:
Mailing address:
  • Phone:
  • 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: SARAH BECHER
Title or Position: MEMBER
Credential:
Phone: --