Provider Demographics
NPI:1134811367
Name:ARABELLA OF CARRABELLE OPCO LLC
Entity type:Organization
Organization Name:ARABELLA OF CARRABELLE OPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:N
Authorized Official - Last Name:HERTZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-930-6124
Mailing Address - Street 1:239 CROOKED RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CARRABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:32322-8040
Mailing Address - Country:US
Mailing Address - Phone:850-697-2020
Mailing Address - Fax:850-697-2377
Practice Address - Street 1:239 CROOKED RIVER RD
Practice Address - Street 2:
Practice Address - City:CARRABELLE
Practice Address - State:FL
Practice Address - Zip Code:32322-8040
Practice Address - Country:US
Practice Address - Phone:850-697-2020
Practice Address - Fax:850-697-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility