Organization
MEDINA BSD OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTISYAHU NUSSBAUM (CEO)
(845) 608-9064
Entity
Organization
Contact information
Practice address
550 MINER DR, MEDINA, OH 44256-1472
(330) 725-7550
Mailing address
5140 US HIGHWAY 9 STE 1, HOWELL, NJ 07731-3357
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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