ST. JUDE OPERATING COMPANY, LLC (NPI# 1205053600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205053600 |
| Entity Type | Organization |
| Organization Name | ST. JUDE OPERATING COMPANY, LLC |
| Other Organization Name | HEALTHCARE AT FOSTER CREEK |
| Practice Address |
6003 Se 136th Ave Portland OR 97236-4567 |
| Practice Telephone | 5037611155 |
| Practice Fax Number | 5037611142 |
| Mailing Telephone | 5037611155 |
| Mailing Fax Number | 5037611142 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2015-12-15 |
| Authorized Official Name | MELCHOR BALAZS (OWNER) |
| Authorized Official Telephone | 5105262230 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 1026862561 | OR | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Healthcare at Foster Creek | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ST. JUDE OPERATING COMPANY, LLC | 6003 Se 136th Ave, Portland, OR 97236 |
| Street Address |
6003 SE 136TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-4567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962025809 | Sapphire At Cedar Crossings, LLC | Skilled Nursing Facility | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2020-05-27 |
| 1568008654 | Jennifer Blair | Counselor | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2019-11-23 |
| 1982254579 | Miranda Boyte | Occupational Therapy Assistant | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2019-09-16 |
| 1982179644 | Abhinaya Srinivasan | Speech-Language Pathologist | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2018-10-09 |
| 1457765612 | Camelia Mayfield | Case Manager/Care Coordinator | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2014-06-16 |
| 1538598206 | Jacqueline Bitner | Case Manager/Care Coordinator | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2013-11-04 |
| 1164864930 | Diana Gates | Counselor | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2013-07-22 |
| 1164784526 | Bryan Joseph Ingram | Adult Companion | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2012-06-12 |
| 1952667669 | Foster Creek Operating Company, LLC | Nursing Facility/Intermediate Care Facility | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2012-04-06 |
| 1760757579 | Sarah Nicole Dowdy | Case Manager/Care Coordinator | 6003 Se 136th Ave, Portland, OR 97236-4567 | 2012-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
| Find all providers in zip 97236 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114492519 | Maple Hollow Rehabilitation and Nursing LLC | Nursing Facility/Intermediate Care Facility | 34 Ne 20th Ave, Portland, OR 97232-3019 | 2018-10-11 |
| 1124550322 | Lisa's Healing and Helping Hands | Nursing Facility/Intermediate Care Facility | 11832 Ne Couch St, Portland, OR 97220-2358 | 2017-03-28 |
| 1639227036 | Marquis Companies | Nursing Facility/Intermediate Care Facility | 6630 Sw Beaverton Hillsdale Hwy, Portland, OR 97225-1404 | 2007-01-08 |
| 1164525077 | Lawrence Convalescent Center | Nursing Facility/Intermediate Care Facility | 812 Se 48th Ave, Portland, OR 97215-1724 | 2006-09-06 |
| 1437180486 | Cornerstone Care Option | Nursing Facility/Intermediate Care Facility | 12640 Se Bush St, Portland, OR 97236-3423 | 2006-07-06 |
| 1811987779 | Fernhill Estates, LLC | Nursing Facility/Intermediate Care Facility | 5737 Ne 37th Ave, Portland, OR 97211-7905 | 2005-10-24 |
| 1750377115 | Robison Jewish Home | Nursing Facility/Intermediate Care Facility | 6125 Sw Boundary St, Portland, OR 97221-1019 | 2005-09-21 |
| 1023670114 | Sapphire At Rose City, LLC | Nursing Facility/Intermediate Care Facility | 34 Ne 20th Ave, Portland, OR 97232-3019 | 2019-06-28 |
| 1295178887 | Marquis Companies II, Inc. | Nursing Facility/Intermediate Care Facility | 6630 Sw Beaverton Hillsdale Hwy, Portland, OR 97225-1404 | 2013-04-12 |
| 1679819411 | Rose Villa, Inc. | Nursing Facility/Intermediate Care Facility | 13505 Se River Rd, Portland, OR 97222-8038 | 2012-12-26 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.