1711 East Broad Street Opco LLC
NPI 1356159206 · Skilled Nursing Facility · Hazleton, PA
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
1711 East Broad Street Opco LLC is a Skilled Nursing Facility organization in Hazleton, PA (NPI 1356159206).
Provider details
- NPI number
- 1356159206
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Tiffany Hoback, Manager(770) 698-9040
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- The Manor at St. Luke Village
Registry dates
- Enumerated
- 2024-12-24
- Last updated
- 2025-03-10
- Certified
- 2025-03-10
Frequently asked questions
- What is 1711 East Broad Street Opco LLC's NPI number?
- 1711 East Broad Street Opco LLC's National Provider Identifier (NPI) is 1356159206, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 1711 East Broad Street Opco LLC?
- 1711 East Broad Street Opco LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is 1711 East Broad Street Opco LLC located?
- 1711 East Broad Street Opco LLC's practice location on file with NPPES is 1711 E Broad St, Hazleton, PA 18201-5691.
- What is 1711 East Broad Street Opco LLC's phone number?
- The practice phone number listed in the NPPES registry for 1711 East Broad Street Opco LLC is (570) 453-5100.
- Does 1711 East Broad Street Opco LLC accept Medicare?
- 1711 East Broad Street Opco LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for 1711 East Broad Street Opco LLC?
- The authorized official listed on 1711 East Broad Street Opco LLC's NPPES record is Tiffany Hoback, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 1711 East Broad Street Opco LLC's NPI active?
- Yes — 1711 East Broad Street Opco LLC's NPI (1356159206) is active in the NPPES registry as of the last update on 2025-03-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.