Healthcare Provider Details

I. General information

NPI: 1497607311
Provider Name (Legal Business Name): FOSTORIA OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CHRISTOPHER DR
FOSTORIA OH
44830-3318
US

IV. Provider business mailing address

1245 HEWLETT PLZ UNIT 141
HEWLETT NY
11557-4006
US

V. Phone/Fax

Practice location:
  • Phone: 419-435-8112
  • Fax:
Mailing address:
  • Phone: 419-340-4478
  • 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: DAVID SKOLNICK
Title or Position: MEMBER
Credential:
Phone: 419-340-4478