Healthcare Provider Details

I. General information

NPI: 1457150609
Provider Name (Legal Business Name): BIG RAPIDS MI OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 WEST AVE
BIG RAPIDS MI
49307-9274
US

IV. Provider business mailing address

805 WEST AVE
BIG RAPIDS MI
49307-9274
US

V. Phone/Fax

Practice location:
  • Phone: 231-796-3185
  • Fax: 231-796-3115
Mailing address:
  • Phone: 231-796-3185
  • Fax: 231-796-3115

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: MR. JACOB TAUB
Title or Position: COO
Credential:
Phone: 718-838-1500