Clarkston Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CLARKSTON OPCO LLC

Doing business as

Villa at Pine Place

Practice address

4800 Clintonville Rd
Clarkston, MI 48346-4297

Phone

(248) 674-0903

Fax

(248) 674-3431

NPI assigned

Sep 30, 2025

Last updated

Aug 27, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marcella Graf

Title

Cfo

Phone

(224) 470-2044

Specialties & licenses 1

Addresses

Other names 1

• Villa at Pine Place Doing business as

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1759190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1114891587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 W LUNT AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122615",
            "telephone_number": "224-470-2044",
            "fax_number": "224-470-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 CLINTONVILLE RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464297",
            "telephone_number": "248-674-0903",
            "fax_number": "248-674-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-30",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "GRAF",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "224-470-2044"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4800 Clintonville Rd",
            "city": "Clarkston",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483464297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Villa at Pine Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clarkston Operating Company LLC (Clarkston Specialty Healthcare Center)
• Clarkston Pediatric Dentistry PLC
• Clarkston Urgent Care PLC
• Clarkston Urgent Care PLC
• Clarkston Vision Care

• Skilled Nursing Facility in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.