# OPTALIS KINGSFORD OPCO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optalis Health and Rehabilitation of Kingsford
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144926726
- **Authorized official:** BETTY USITALO (ADMINISTRATOR)
- **Authorized official phone:** (906) 774-4805

## Contact information

- **Practice address:** 1225 WOODWARD AVE, KINGSFORD, MI 49802-4312
- **Practice address phone:** (906) 774-4805
- **Mailing address:** 1225 WOODWARD AVE, KINGSFORD, MI 49802-4312
- **Mailing address phone:** (906) 774-4805
- **Mailing address fax:** (269) 279-6173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2023
- **Last updated:** 06/19/2026