MEDICARE: OPCO CLEVELAND, OK, 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1255920104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPCO CLEVELAND, OK, LLC

Provider Business Mailing Address
First Line	:	2045 W GRAND AVE STE B34572
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-1576
Country	:	US
Telephone Number	:	312-724-8950
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 N DIVISION ST
Second Line	:
City	:	CLEVELAND
State	:	OK
Zip	:	74020-1222
Country	:	US
Telephone Number	:	918-358-3135
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT OF MANAGER
Name	:	ISAAC DOLE
Credential	:
Telephone Number	:	773-645-9246

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	10/29/2024

Similar Medicare Providers

1194805556 — SWEET TOWN, LLC
Practice Location Address:

900 N DIVISION ST
CLEVELAND, OK
74020-1222

Practice Phone: 918-358-3135
Practice Fax:

1679257596 — CLEVELAND HEALTHCARE, LLC
Practice Location Address:

900 N DIVISION ST
CLEVELAND, OK
74020-1222

Practice Phone: 918-358-3135
Practice Fax:

1275703647 — BRENDA JANICE WALLACE RN,C
Practice Location Address:

3107 EASTWICK DR
CLEVELAND HEIGHTS, OH
44118-1222

Practice Phone: 216-371-5253
Practice Fax:

1194992297 — DR. TREVOR G MURRAY M.D.
Practice Location Address:

9500 EUCLID AVE
CLEVELAND, OH
44195-1222

Practice Phone: 216-444-3743
Practice Fax: 630-682-8946

1053737858 — LORETTA HILL EMBRY
Practice Location Address:

17914 EUCLID AVE
CLEVELAND, OH
44112-1222

Practice Phone: 216-920-1855
Practice Fax:

1023792389 — CARRIE STANDBERRY
Practice Location Address:

1389 E 109TH ST
CLEVELAND, OH
44106-1222

Practice Phone: 216-571-7820
Practice Fax:

Directions to “OPCO CLEVELAND, OK, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.