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NPI Code Detail

MEDICARE: WARREN OPCO, LLC

MEDICARE: WARREN OPCO, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245610328
Entity Type Code : Organization
Provider Name (Legal Business Name) : WARREN OPCO, LLC
Provider Business Mailing Address
First Line : 3755 CHASE AVE
Second Line :
City : SKOKIE
State : IL
Zip : 60076-4008
Country : US
Telephone Number : 847-440-2660
Fax Number :
Provider Business Practice Location Address
First Line : 11700 E 10 MILE RD
Second Line :
City : WARREN
State : MI
Zip : 48089-3903
Country : US
Telephone Number : 586-759-5960
Fax Number :
Authorized Official
Title or Position : CFO
Name : MARCELLA GRAF
Credential :
Telephone Number : 224-470-2044
Provider Enumeration Date : 06/04/2015
Last Update Date : 11/04/2025

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Directions to “WARREN OPCO, LLC ” Practice Location

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