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General NPI Number Information
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NPI Number | 1417760463
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Entity Type | Organization
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Legal Business Name | CS AL OPCO LLC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 1340 MAHONING AVE NW
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City | WARREN
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State | OH
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Zip | 44483-2084
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Country | US
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Telephone | 330-394-3037
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Fax |
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Provider Business Mailing Address
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Address Line | 5140 US HIGHWAY 9
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City | HOWELL
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State | NJ
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Zip | 07731-3357
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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 | OWNER
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Name | MATTISYAHU NUSSBAUM
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Credential |
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Telephone | 212-653-8730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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