MEDICARE: M OAKS 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
1	314000000X	Skilled Nursing Facility

Other Identifiers

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

General Provider Information

NPI Number	:	1295449981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M OAKS OPCO LLC

Provider Business Mailing Address
First Line	:	180 SYLVAN AVE
Second Line	:	SUITE 4
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-2519
Country	:	US
Telephone Number	:	201-731-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 E COMMERCIAL BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3821
Country	:	US
Telephone Number	:	954-771-8400
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MARK FRIEDMAN
Credential	:
Telephone Number	:	917-596-1800

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	06/07/2024

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Directions to “M OAKS OPCO LLC ” Practice Location

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