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Organization

WHITE OAK DIVINE OPCO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY DEGYANSKY (CHIEF OPERATING OFFICER)
(330) 620-7828
Entity
Organization

Contact information

Practice address
4420 SOUTH AVE, TOLEDO, OH 43615-6417
(330) 620-7828
Mailing address
5915 LANDERBROOK DR STE 350, MAYFIELD HEIGHTS, OH 44124-4063

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
04/30/2025
Last updated
04/30/2025
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