Provider Demographics
NPI:1104679091
Name:MH SNF OPCO, LLC
Entity type:Organization
Organization Name:MH SNF OPCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-608-6734
Mailing Address - Street 1:5679 ROYAL OAK WAY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6386
Mailing Address - Country:US
Mailing Address - Phone:917-608-6734
Mailing Address - Fax:
Practice Address - Street 1:9945 CENTRAL PARK BLVD N
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1745
Practice Address - Country:US
Practice Address - Phone:561-483-0498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility