Healthcare Provider Details

I. General information

NPI: 1467373183
Provider Name (Legal Business Name): 11608 SCOTT SIMPSON DR OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11608 SCOTT SIMPSON DR
EL PASO TX
79936-6210
US

IV. Provider business mailing address

11608 SCOTT SIMPSON DR
EL PASO TX
79936-6210
US

V. Phone/Fax

Practice location:
  • Phone: 915-857-0071
  • Fax:
Mailing address:
  • Phone: 915-857-0071
  • 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: NOCHUM FREUND
Title or Position: CEO
Credential:
Phone: 732-719-5098