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General NPI Number Information
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NPI Number | 1326489634
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Entity Type | Organization
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Legal Business Name | PLYMOUTH OPCO LLC
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 395 W ANN ARBOR TRL
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City | PLYMOUTH
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State | MI
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Zip | 48170-1641
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Country | US
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Telephone | 734-453-3983
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Fax | 734-414-8231
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Provider Business Mailing Address
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Address Line | 7400 NEW LA GRANGE RD SUITE 100
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City | LOUISVILLE
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State | KY
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Zip | 40222-4870
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Country | US
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Telephone | 502-429-8062
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Fax | 502-429-0650
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. STACEY PAUL ROGERS
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Credential |
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Telephone | 502-429-8062
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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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