405 Stanaford Road Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

405 STANAFORD ROAD OPCO, LLC

Doing business as

Pine Lodge Post Acute

Practice address

405 Stanaford Rd
Beckley, WV 25801-3143

Phone

(323) 928-9445

NPI assigned

Mar 9, 2026

Last updated

Oct 16, 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

Avrohom Tress

Title

Executive Vice President

Phone

(323) 928-9445

Specialties & licenses 1

Addresses

Other names 1

• Pine Lodge Post Acute Doing business as

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

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792108800000",
    "number": "1831045145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9526 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 STANAFORD RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013143",
            "telephone_number": "323-928-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "405 STANAFORD ROAD OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A",
        "authorized_official_last_name": "TRESS",
        "authorized_official_first_name": "AVROHOM",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "323-928-9445"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Lodge Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.