Organization
OPTALIS BLACKLICK OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJ PATEL (CEO)
(248) 692-4355
Entity
Organization
Contact information
Practice address
195 BLOSSOM FIELD BLVD, COLUMBUS, OH 43213
(614) 655-6554
Mailing address
195 BLOSSOM FIELD BLVD, COLUMBUS, OH 43213
(614) 655-6554
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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