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General NPI Number Information
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NPI Number | 1083569982
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Entity Type | Organization
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Legal Business Name | 35 BEL AIRE DRIVE OPCO, LLC
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 35 BEL AIRE DR
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City | NEWPORT
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State | VT
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Zip | 05855-4953
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Country | US
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Telephone | 323-928-9445
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Fax |
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Provider Business Mailing Address
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Address Line | 9526 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-1202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | AVROHOM TRESS
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Credential |
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Telephone | 323-928-9445
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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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