=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104712140
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CVRC OPCO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2025
-----------------------------------------------------
Last Update Date | 06/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6655 FRANKSTOWN AVE
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15206-4148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-665-3232
-----------------------------------------------------
Fax | 814-240-1207
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6655 FRANKSTOWN AVE
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15206-4148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-665-3232
-----------------------------------------------------
Fax | 814-240-1207
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | YAAKOV GELDZAHLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-639-1022
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------