1711 East Broad Street Opco LLC
NPI 1356159206ActiveOrganization· Skilled Nursing Facility· Hazleton, PA
Skilled Nursing Facility in Hazleton, Pennsylvania, registered in NPPES in December 2024. The authorized official on file is Tiffany Hoback, Manager. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1356159206 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 24, 2024 |
| Last updated in NPPES | Mar 10, 2025 |
| Certified by provider | Mar 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (PA) |
|---|
Other Skilled Nursing Facility providers in Hazleton
- 1174331029
- 1275547036
- 1861518839
- 1578516423
- 1760423065
- 1285674143
- 1437163292