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General NPI Number Information
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NPI Number | 1932997590
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Entity Type | Organization
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Legal Business Name | LIVONIA OPCO LLC
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 29270 MORLOCK ST
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City | LIVONIA
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State | MI
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Zip | 48152-2044
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Country | US
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Telephone | 248-475-0555
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Fax | 248-477-5391
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Provider Business Mailing Address
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Address Line | 29270 MORLOCK ST
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City | LIVONIA
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State | MI
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Zip | 48152-2044
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Country | US
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Telephone | 248-476-0555
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Fax | 248-477-5391
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | KRISTINE RANEL KIRK
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Credential |
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Telephone | 417-846-3521
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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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