400 South Independence Avenue Opco LLC
NPI #1033927074 in Independence, Virginia
Provider Information
- NPI Number
- 1033927074
- Entity Type
- Organization
- Organization Name
- 400 South Independence Avenue Opco LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Dec 23, 2024
- Last Updated
- Mar 10, 2025
Practice Location
- Address
- 400 S INDEPENDENCE AVE
- City
- Independence
- State
- Virginia
- ZIP Code
- 24348-3972
- Phone
- (276) 773-0303
Authorized Official
- Name
- TIFFANY HOBACK
- Title
- MANAGER
- Phone
- (770) 698-9040
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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