Organization
ELLISVILLE OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAZAR FISCHER (MANAGER)
(636) 227-3431
Entity
Organization
Contact information
Practice address
322 OLD STATE RD, ELLISVILLE, MO 63021-5917
(636) 227-3431
Mailing address
1135 E VETERANS HWY STE 102, JACKSON, NJ 08527-5092
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/21/2024
Last updated
05/23/2024
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