# 4405 AIRLINE DRIVE OPCO LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437915477
- **Authorized official:** SHLOMO MUSHELL (MANAGER)
- **Authorized official phone:** (917) 251-5131

## Contact information

- **Practice address:** 4405 AIRLINE DR, BOSSIER CITY, LA 71111-2058
- **Practice address phone:** (318) 747-5440
- **Practice address fax:** (318) 747-5040
- **Mailing address:** 4405 AIRLINE DR, BOSSIER CITY, LA 71111-2058
- **Mailing address phone:** (318) 747-5440
- **Mailing address fax:** (318) 747-5040

## Taxonomy

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

## Other

- **Enumeration date:** 02/27/2024
- **Last updated:** 08/23/2024