Healthcare Provider Details
I. General information
NPI: 1235092230
Provider Name (Legal Business Name): BRADFORD PA OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 LANGMAID LN
BRADFORD PA
16701-3930
US
IV. Provider business mailing address
300 BOULEVARD OF THE AMERICAS SUITE 101
LAKEWOOD NJ
08701
US
V. Phone/Fax
- Phone: 814-362-6090
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AHARON
FRANCO
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 646-823-6464