Provider Demographics
NPI:1982497970
Name:233 CARROLLTON OPCO LLC
Entity type:Organization
Organization Name:233 CARROLLTON OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AVROHOM
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLODNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-646-3861
Mailing Address - Street 1:233 CARROLLTON ST
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:GA
Mailing Address - Zip Code:30113-4917
Mailing Address - Country:US
Mailing Address - Phone:770-646-3861
Mailing Address - Fax:
Practice Address - Street 1:233 CARROLLTON ST
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:GA
Practice Address - Zip Code:30113-4917
Practice Address - Country:US
Practice Address - Phone:770-646-3861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility