Provider Demographics
NPI:1598578809
Name:600 WEST VALLEY FORGE ROAD OPCO LLC
Entity type:Organization
Organization Name:600 WEST VALLEY FORGE ROAD OPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF SOLE MEMBER, OPA OPCO PA
Authorized Official - Prefix:
Authorized Official - First Name:YISSOCHOR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-510-8029
Mailing Address - Street 1:600 W VALLEY FORGE RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1571
Mailing Address - Country:US
Mailing Address - Phone:610-337-1775
Mailing Address - Fax:
Practice Address - Street 1:600 W VALLEY FORGE RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1571
Practice Address - Country:US
Practice Address - Phone:610-337-1775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPA OPCO PARENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility