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115 South Providence Road Opco LLC — NPI 1083427306, Wallingford, PA | NPI Central

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NPI 1083427306

OrganizationActive

115 South Providence Road Opco LLC

NPI 1083427306 · Skilled Nursing Facility · Wallingford, PA

Provider details

NPI number: 1083427306
Entity type: Organization
Primary specialty: Skilled Nursing FacilityNursing & Custodial Care Facilities
Parent organization: Opa Opco Parent LLC
Organization subpart: Yes
Authorized official: Yissochor Komin, Manager of Sole Member, Opa Opco PA(908) 510-8029

Specialties & taxonomies

Skilled Nursing FacilityPrimary314000000X
Nursing & Custodial Care Facilities

Practice location

115 S Providence Rd

Wallingford, PA 19086-6333

Phone: (610) 565-3232

Approximate (ZIP-level) locationGet directions

More PA providers

Mailing address

115 S Providence Rd

Wallingford, PA 19086-6333

Other names (DBA / former)

Doing business as: Altira at Wallingford

Registry dates

Enumerated: 2025-01-30
Last updated: 2025-01-30
Certified: 2025-01-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.