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Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

115 South Providence Road Opco LLC

Skilled Nursing Facility in Wallingford, PA · enumerated 2025 · authorized official Yissochor Komin, Manager of Sole Member, Opa Opco PA.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1083427306

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Registry record

Entity type Organization (Type 2)
Legal business name 115 South Providence Road Opco LLC
Parent organization Opa Opco Parent LLC
Practice address 115 S Providence Rd, Wallingford, PA, 19086
Phone (610) 565-3232
Enumeration date Jan 30, 2025
Last updated in NPPES Jan 30, 2025

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities Primary

Authorized official

Name Yissochor Komin
Title Manager of Sole Member, Opa Opco PA
Phone (908) 510-8029

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for 115 South Providence Road Opco LLC?
The NPI for 115 South Providence Road Opco LLC is 1083427306, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for 115 South Providence Road Opco LLC?
NPPES lists Yissochor Komin (Manager of Sole Member, Opa Opco PA) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-01-30.