OrganizationActive
1530 Broad Avenue Operations, LLC
NPI 1306593900 · Skilled Nursing Facility · Gulfport, MS
Provider details
- NPI number
- 1306593900
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Authorized official
- Tim Lehner, Manager
Practice location
1530 Broad Ave
Gulfport, MS 39501-3601
Phone: (253) 278-2258
Fax: (228) 868-8544
Mailing address
1530 Broad Ave
Gulfport, MS 39501-3601
Registry dates
- Enumerated
- 2022-03-04
- Last updated
- 2024-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.