Healthcare Provider Details

I. General information

NPI: 1679356125
Provider Name (Legal Business Name): VOORHEES ROAD OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4927 VOORHEES RD
NEW PORT RICHEY FL
34653-5542
US

IV. Provider business mailing address

4927 VOORHEES RD
NEW PORT RICHEY FL
34653-5542
US

V. Phone/Fax

Practice location:
  • Phone: 727-848-3578
  • 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: AMITAI DAGAN
Title or Position: AUTHORIZED MEMBER
Credential:
Phone: 732-730-7270