Organization
OPTALIS WYOMING OPCO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJ PATEL (CEO)
(248) 692-4355
Entity
Organization
Contact information
Practice address
625 36TH ST SW, WYOMING, MI 49509-4004
(616) 975-2180
(616) 531-0407
Mailing address
625 36TH ST SW, WYOMING, MI 49509-4004
(616) 975-2180
(616) 531-0407
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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