St. Jude Nursing Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

824260 Issued in MI

Legal business name

ST. JUDE NURSING CENTER, INC.

Practice address

34350 Ann Arbor TRL
Livonia, MI 48150-3606

Phone

(734) 261-4800

Fax

(734) 261-0430

NPI assigned

May 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bradley J.M. Mali

Title

Owner

Phone

(734) 261-4800

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1801854815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34350 ANN ARBOR TRL",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503606",
            "telephone_number": "734-261-4800",
            "fax_number": "734-261-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34350 ANN ARBOR TRL",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503606",
            "telephone_number": "734-261-4800",
            "fax_number": "734-261-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "MALI",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J.M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-261-4800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "824260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4797426",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "09568",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "824260",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Livonia, MI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.