Organization · NPI-2

5380 E Broad St Opco, LLC

Assisted Living Facility · Columbus, OH

NPI number1952207086
StatusActive
Last updated in NPPESOct 16, 2026

Details

NPI
1952207086
Entity type
Organization (NPI-2)
Legal business name
5380 E Broad St Opco, LLC
Organization subpart
No
Enumeration date
Oct 15, 2026
Certification date
Oct 16, 2026
Last updated
Oct 16, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living Facility––Yes

Practice location

5380 E Broad St
Columbus, OH 43213-1391

Phone 908-783-1182

Mailing address

134 Mantoloking Dr
Jackson, NJ 08527-3225

Phone 908-783-1182

Authorized official

Edward K Netzer
Owner
9087831182

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