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General NPI Number Information
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NPI Number | 1023972957
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Entity Type | Organization
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Legal Business Name | SOUTHERLAND OPCO LLC
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 333 MAPLE ST
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City | SUTHERLAND
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State | NE
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Zip | 69165-3000
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Country | US
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Telephone | 308-692-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 333 MAPLE ST
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City | SUTHERLAND
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State | NE
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Zip | 69165-3000
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Country | US
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Telephone | 308-692-3100
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Fax |
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Authorized Official
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Title or Position | REGIONAL DIRECTOR OF OPERATIONS
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Name | ABRAHAM SMILOW
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Credential |
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Telephone | 917-543-4391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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