Healthcare Provider Details

I. General information

NPI: 1851268957
Provider Name (Legal Business Name): CLAWSON OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 N MAIN ST
CLAWSON MI
48017-1526
US

IV. Provider business mailing address

535 N MAIN ST
CLAWSON MI
48017-1526
US

V. Phone/Fax

Practice location:
  • Phone: 248-435-5200
  • Fax: 248-435-4660
Mailing address:
  • Phone: 248-435-5200
  • Fax: 248-435-4660

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: TIFFANY M LOCKHART
Title or Position: CFO
Credential:
Phone: 330-223-8200