Organization
GLISAN SNF HEALTHCARE LLC
Active
Other names
Glisan Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA JERGENSEN (PRESIDENT)
(801) 447-9829
Entity
Organization
Contact information
Practice address
9750 NE GLISAN ST, PORTLAND, OR 97220-4449
(503) 256-3920
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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