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NPI Code Detail

MEDICARE: OPTALIS STERLING HEIGHTS OPCO LLC

MEDICARE: OPTALIS STERLING HEIGHTS 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

General Provider Information

NPI Number : 1255037834
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTALIS STERLING HEIGHTS OPCO LLC
Provider Business Mailing Address
First Line : 38200 SCHOENHERR RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48312-1700
Country : US
Telephone Number : 586-274-9044
Fax Number : 586-268-2216
Provider Business Practice Location Address
First Line : 38200 SCHOENHERR RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48312-1700
Country : US
Telephone Number : 586-274-9044
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : KEVIN BANDUR
Credential :
Telephone Number : 586-274-9044
Provider Enumeration Date : 02/06/2023
Last Update Date : 06/19/2026

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