1711 East Broad Street Opco LLC
NPI #1356159206 in Hazleton, Pennsylvania
Provider Information
- NPI Number
- 1356159206
- Entity Type
- Organization
- Organization Name
- 1711 East Broad Street Opco LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Dec 24, 2024
- Last Updated
- Mar 10, 2025
Practice Location
- Address
- 1711 E BROAD ST
- City
- Hazleton
- State
- Pennsylvania
- ZIP Code
- 18201-5691
- Phone
- (570) 453-5100
Authorized Official
- Name
- TIFFANY HOBACK
- Title
- MANAGER
- Phone
- (770) 698-9040
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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