NPI 1205053600

St. Jude Operating Company, LLC

Organisation Nursing Facility/Intermediate Care Facility Portland, OR

Practice location

Address: 6003 SE 136th Ave, Portland, OR 97236-4567
Phone: (503) 761-1155
Fax: (503) 761-1142

Authorised official

Name: Melchor Balazs
Title: Owner
Phone: (510) 526-2230

Registered specialties

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 1026862561 (OR)

Other Nursing Facility/Intermediate Care Facility providers in Oregon →

Registry record

NPI: 1205053600
Entity type: Organization
NPI issued: 19 Apr 2007
Record last updated: 15 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.