Healthcare Provider Details

I. General information

NPI: 1912683095
Provider Name (Legal Business Name): ASHEBORO OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 06/23/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VISION DR
ASHEBORO NC
27203-3855
US

IV. Provider business mailing address

211 BLVD OF THE AMERICAS SUITE 500
LAKEWOOD NJ
08701
US

V. Phone/Fax

Practice location:
  • Phone: 908-506-4204
  • 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: TZVI ALTER
Title or Position: CEO
Credential:
Phone: 908-506-4204