NPI 1114891587 · live from the CMS NPI Registry
Clarkston Opco LLC
Skilled Nursing Facility in Clarkston, MI. National Provider Identifier 1114891587, active.
NPI record
| NPI | 1114891587 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 4800 Clintonville Rd, Clarkston, MI 48346 |
| Practice phone | 248-674-0903 |
| Mailing address | 3701 W Lunt Ave, Lincolnwood, IL 60712 |
| Enumerated | September 30, 2025 |
| Last updated | August 27, 2026 |
| Authorized official | Marcella Graf, Cfo |
| Other names | Villa At Pine Place |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.