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General NPI Number Information
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NPI Number | 1215473194
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Entity Type | Organization
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Legal Business Name | HOLLAND OPCO II, LLC
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Dates
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Enumeration Date | 01/16/2017
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Last Update Date | 04/02/2017
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Provider Practice Location Address
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Address Line | 493 W 32ND ST
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City | HOLLAND
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State | MI
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Zip | 49423-7201
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Country | US
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Telephone | 616-396-1438
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Fax |
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Provider Business Mailing Address
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Address Line | 493 W 32ND ST
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City | HOLLAND
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State | MI
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Zip | 49423-7201
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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 | MEMBER
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Name | SIMCHA MANDELBAUM
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Credential |
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Telephone | 847-344-8712
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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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