# SAULT STE. MARIE OPCO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medilodge of Sault Ste. Marie
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801313135
- **Authorized official:** MR. STACEY PAUL ROGERS (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (502) 429-8062

## Contact information

- **Practice address:** 1011 MERIDIAN ST, SAULT SAINTE MARIE, MI 49783-2650
- **Practice address phone:** (906) 635-1518
- **Mailing address:** 7400 NEW LA GRANGE RD STE 100, LOUISVILLE, KY 40222-4870
- **Mailing address phone:** (502) 429-8062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 08/28/2017
- **Last updated:** 08/28/2017