Provider Demographics
NPI:1750888145
Name:WELLTOWER CCRC OPCO LLC
Entity type:Organization
Organization Name:WELLTOWER CCRC OPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR REIMBURSEMENT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-854-0830
Mailing Address - Street 1:2600 BARRACKS RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2271
Mailing Address - Country:US
Mailing Address - Phone:434-963-4198
Mailing Address - Fax:804-963-4108
Practice Address - Street 1:2600 BARRACKS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2271
Practice Address - Country:US
Practice Address - Phone:434-963-4198
Practice Address - Fax:804-963-4108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLTOWER CCRC OPCO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-11
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility