Organization
ST. JUDE OPERATING COMPANY, LLC
Active
Other names
Healthcare at Foster Creek
Organization subpart
No
Provider details
NPI number
Authorized official
MELCHOR BALAZS (OWNER)
(510) 526-2230
Entity
Organization
Contact information
Practice address
6003 SE 136TH AVE, PORTLAND, OR 97236-4567
(503) 761-1155
(503) 761-1142
Mailing address
6003 SE 136TH AVE, PORTLAND, OR 97236-4567
(503) 761-1155
(503) 761-1142
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1026862561
OR
Other
Enumeration date
04/19/2007
Last updated
12/15/2015
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