Provider Demographics
NPI:1346658473
Name:S-H OPCO FOX RIVER, LLC
Entity type:Organization
Organization Name:S-H OPCO FOX RIVER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRAGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-728-9063
Mailing Address - Street 1:5800 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-7563
Mailing Address - Country:US
Mailing Address - Phone:920-997-0725
Mailing Address - Fax:
Practice Address - Street 1:5800 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-7563
Practice Address - Country:US
Practice Address - Phone:920-997-0725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility