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General NPI Number Information
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NPI Number | 1356285282
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Entity Type | Organization
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Legal Business Name | MICHIGAN BS OPCO LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 21630 HESSEL AVE # 1230
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City | DETROIT
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State | MI
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Zip | 48219-1230
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Country | US
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Telephone | 313-534-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 2360 LAKEWOOD RD STE 2
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1929
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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 | MANAGER
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Name | MENACHEM P KOFMAN
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Credential |
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Telephone | 732-908-1218
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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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