Healthcare Provider Details

I. General information

NPI: 1962211383
Provider Name (Legal Business Name): ALPINE OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2024
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 OFFICE PARK DR
XENIA OH
45385-1647
US

IV. Provider business mailing address

5308 13TH AVE # 398
BROOKLYN NY
11219-5198
US

V. Phone/Fax

Practice location:
  • Phone: 937-419-4500
  • Fax:
Mailing address:
  • Phone: 732-639-1022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHAIM AUSCH
Title or Position: OWNER
Credential:
Phone: 732-639-1022