1B
1530 BROAD AVENUE OPERATIONS, LLC
Skilled Nursing Facility
OIG CLEARNPI VERIFIED
Location
GULFPORT, MS
Licensed since
2022
Rate
—
Federal identifiers
NPI registry number1306593900
Agency details
Medicare activity
StatusNo Medicare utilization on file — neutral.
Authorized official
NameTIM LEHNER
TitleMANAGER
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