# ST JUDE NURSING HOME INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST JUDE HEALTHCARE SERVICES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275902348
- **Authorized official:** HECTOR E JACA RN, MBA-HCM (CEO)
- **Authorized official phone:** (787) 776-3013

## Contact information

- **Practice address:** 1214 CALLE JOSE ABAD, CLUB MANOR, SAN JUAN, PR 00924-4336
- **Practice address phone:** (787) 776-3013
- **Practice address fax:** (787) 762-9334
- **Mailing address:** PO BOX 9117, PLAZA CAROLINA STATION, CAROLINA, PR 00988-9117
- **Mailing address phone:** (787) 776-3013
- **Mailing address fax:** (787) 762-9334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 04 | PR | Yes |

## Other

- **Enumeration date:** 09/18/2015
- **Last updated:** 09/18/2015