Provider Demographics
NPI:1174290100
Name:GA OPCO LLC
Entity Type:Organization
Organization Name:GA OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNATORY
Authorized Official - Prefix:
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-564-2015
Mailing Address - Street 1:411 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-2035
Mailing Address - Country:US
Mailing Address - Phone:912-564-2015
Mailing Address - Fax:912-564-9218
Practice Address - Street 1:411 PINE ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:GA
Practice Address - Zip Code:30467-2035
Practice Address - Country:US
Practice Address - Phone:912-564-2015
Practice Address - Fax:912-564-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility