Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wickshire Port Orange Opco LLC

Organization Assisted Living Facility · NPI 1023616943

Wickshire Port Orange Opco LLC is an Assisted Living Facility in Port Orange, Florida. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1675 Dunlawton Ave
Port Orange, FL 32127-4755
Phone: (386) 761-1055
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X
Alzheimer Center (Dementia Center) Taxonomy 311500000X

Record details

NPI number1023616943
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dan O'Keefe — Ceo · (615) 942-0240
Other names Wickshire Port Orange
NPI enumeratedOctober 13, 2020
Last updated in NPPESOctober 13, 2020
Certification dateOctober 13, 2020
Mailing address750 Old Hickory Blvd, Brentwood, TN 37027-4528

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