24 Cree Drive Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

24 CREE DRIVE OPCO LLC

Practice address

24 Cree Dr
Lock Haven, PA 17745-2639

Phone

(732) 707-9013

NPI assigned

Sep 18, 2024

Organization subpart

No

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

Authorized official

Name

Blimi Aviv

Title

Superivsor

Phone

(973) 285-2893

Specialties & licenses 1

Addresses

Other names 1

• Haven Place Rehabilitation and Nursing Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Boris Goralnik, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Williamsport, PA
  • NPI 1366776742
  NPD (past)

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1215764683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 E COUNTY LINE RD STE 201",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012178",
            "telephone_number": "732-707-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CREE DR",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177452639",
            "telephone_number": "732-707-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "24 CREE DRIVE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "AVIV",
        "authorized_official_first_name": "BLIMI",
        "authorized_official_title_or_position": "SUPERIVSOR",
        "authorized_official_telephone_number": "973-285-2893"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Place Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elena Ackah, M.D.
• Charles V Ackley, D.O.
• Amy Beth Adrian, CRNP
• Bharat G Adroja, M.D.
• Taylor Ahlborn

• Skilled Nursing Facility in Lock Haven, PA
• Providers in Lock Haven, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.