# OPTALIS WYOMING OPCO, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Optalis Health & Rehabilitation of Wyoming
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568258002
- **Authorized official:** SUSAN WORTMAN (ADMINISTRATOR)
- **Authorized official phone:** (616) 531-0200

## Contact information

- **Practice address:** 625 36TH ST SW, WYOMING, MI 49509-4004
- **Practice address phone:** (616) 975-2180
- **Practice address fax:** (616) 531-0407
- **Mailing address:** 625 36TH ST SW, WYOMING, MI 49509-4004
- **Mailing address phone:** (616) 531-0200
- **Mailing address fax:** (616) 531-0407

## Taxonomy

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

## Other

- **Enumeration date:** 04/18/2025
- **Last updated:** 06/19/2026