Organization
GTC OPCO, LLC
Active
Other names
Medilodge of GTC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STACEY PAUL ROGERS (CHIEF FINANCIAL OFFICER)
(502) 429-8062
Entity
Organization
Contact information
Practice address
2950 LAFRANIER RD, TRAVERSE CITY, MI 49686-4918
(231) 947-0506
Mailing address
7400 NEW LA GRANGE RD STE 100, LOUISVILLE, KY 40222-4870
(502) 429-8062
(502) 429-0650
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/17/2017
Last updated
08/28/2017
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