1639 Opco, LLC
NPI #1649156696 in Wilton Manors, Florida
Provider Information
- NPI Number
- 1649156696
- Entity Type
- Organization
- Organization Name
- 1639 Opco, LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Aug 14, 2025
- Last Updated
- Aug 14, 2025
Practice Location
- Address
- 1639 NE 26TH ST
- City
- Wilton Manors
- State
- Florida
- ZIP Code
- 33305-1410
- Phone
- (847) 917-8337
Authorized Official
- Name
- MR. ROBERT CHARLES VAN FOSSAN
- Title
- PRESIDENT
- Phone
- (847) 917-8337
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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