Provider Demographics
NPI:1518220615
Name:OPHC, LLC
Entity Type:Organization
Organization Name:OPHC, LLC
Other - Org Name:OAKPARK HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-352-4426
Mailing Address - Street 1:9166 TUJUNGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-3462
Mailing Address - Country:US
Mailing Address - Phone:818-352-4426
Mailing Address - Fax:818-951-5797
Practice Address - Street 1:9166 TUJUNGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-3462
Practice Address - Country:US
Practice Address - Phone:818-352-4426
Practice Address - Fax:818-951-5797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA055360Medicare Oscar/Certification