Provider Demographics
NPI:1033475769
Name:SANTE SNF OP CO, LLC
Entity Type:Organization
Organization Name:SANTE SNF OP CO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-201-8356
Mailing Address - Street 1:1220 20TH ST SE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2321 NW SCHOLD PL
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9504
Practice Address - Country:US
Practice Address - Phone:360-698-3930
Practice Address - Fax:360-613-9520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
505484Medicare Oscar/Certification