Provider Demographics
NPI:1457150609
Name:BIG RAPIDS MI OPCO LLC
Entity type:Organization
Organization Name:BIG RAPIDS MI OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-838-1500
Mailing Address - Street 1:805 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-9274
Mailing Address - Country:US
Mailing Address - Phone:231-796-3185
Mailing Address - Fax:231-796-3115
Practice Address - Street 1:805 WEST AVE
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-9274
Practice Address - Country:US
Practice Address - Phone:231-796-3185
Practice Address - Fax:231-796-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility