Organization
ORTHOPEDIC RESHABILITATION UNIT
Active
Parent organization
ST CATHERINE LABOURE MANOR INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST CATHERINE LABOURE MANOR INC
Authorized official
GENE MIYAMOTO (COO)
(904) 308-1290
Entity
Organization
Contact information
Practice address
1750 STOCKTON ST, JACKSONVILLE, FL 32204-4664
(904) 308-4700
Mailing address
1750 STOCKTON ST, JACKSONVILLE, FL 32204-4664
(904) 308-4700
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1517096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020515000
—
FL
01
—
080473001
DME MAC
FL
Enumeration date
04/25/2011
Last updated
04/25/2011
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