MEDICARE: STEUBENVILLE SNF 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

General Provider Information

NPI Number	:	1649134750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEUBENVILLE SNF OPCO LLC

Provider Business Mailing Address
First Line	:	3102 SAINT CHARLES DR
Second Line	:
City	:	STEUBENVILLE
State	:	OH
Zip	:	43952-3508
Country	:	US
Telephone Number	:	740-264-7161
Fax Number	:

Provider Business Practice Location Address
First Line	:	3102 SAINT CHARLES DR
Second Line	:
City	:	STEUBENVILLE
State	:	OH
Zip	:	43952-3508
Country	:	US
Telephone Number	:	740-264-7161
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL TENENBAUM
Credential	:
Telephone Number	:	917-613-5764

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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