Healthcare Provider Details

I. General information

NPI: 1649187501
Provider Name (Legal Business Name): OLP SNF OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5285 LEWISTON RD
LEWISTON NY
14092-1942
US

IV. Provider business mailing address

5285 LEWISTON RD
LEWISTON NY
14092-1942
US

V. Phone/Fax

Practice location:
  • Phone: 716-298-2900
  • 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: BERNADETTE ROESCH
Title or Position: MANAGING MEMBER
Credential:
Phone: 716-292-1154