Healthcare Provider Details

I. General information

NPI: 1407691041
Provider Name (Legal Business Name): WELLTOWER OPCO GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19310 CLUB HOUSE RD
MONTGOMERY VILLAGE MD
20886-3029
US

IV. Provider business mailing address

19310 CLUB HOUSE RD
MONTGOMERY VILLAGE MD
20886-3029
US

V. Phone/Fax

Practice location:
  • Phone: 301-921-0445
  • Fax: 301-948-7144
Mailing address:
  • Phone: 301-921-0445
  • Fax: 301-948-7144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. TONY J. HARRIS
Title or Position: SENIOR REIMBURSEMENT MANAGER
Credential:
Phone: 703-854-0830