Port Huron Opco LLC
NPI #1942641964 in Fort Gratiot, Michigan
Provider Information
- NPI Number
- 1942641964
- Entity Type
- Organization
- Organization Name
- Port Huron Opco LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 8, 2013
- Last Updated
- Dec 30, 2014
Practice Location
- Address
- 5635 LAKESHORE RD
- City
- Fort Gratiot
- State
- Michigan
- ZIP Code
- 48059-2817
- Phone
- (810) 385-7447
Authorized Official
- Name
- MR. STACEY PAUL ROGERS
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (502) 429-8062
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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