Provider Demographics
NPI:1285095869
Name:MAYBROOK-C SILVER OAKS OPCO, LLC
Entity type:Organization
Organization Name:MAYBROOK-C SILVER OAKS OPCO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNSELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-652-3863
Mailing Address - Street 1:715 HARBOR STREET
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101
Mailing Address - Country:US
Mailing Address - Phone:724-652-3863
Mailing Address - Fax:
Practice Address - Street 1:715 HARBOR ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-2011
Practice Address - Country:US
Practice Address - Phone:724-652-3863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility