# OP EVERETT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pennknoll Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750321535
- **Authorized official:** JOSEPH CONTE (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (407) 571-1550

## Contact information

- **Practice address:** 208 PENNKNOLL RD, EVERETT, PA 15537-6940
- **Practice address phone:** (814) 623-3200
- **Practice address fax:** (814) 623-3202
- **Mailing address:** 800 CONCOURSE PKWY S, SUITE 200, MAITLAND, FL 32751-6148
- **Mailing address phone:** (407) 571-1550
- **Mailing address fax:** (407) 571-1599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 680602 | PA | Yes |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1012268000001 | — | PA |