Provider Demographics
NPI:1902378698
Name:STM VENTURES LLC
Entity Type:Organization
Organization Name:STM VENTURES LLC
Other - Org Name:ST. JUDE'S NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:STANSBERRY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:504-279-6414
Mailing Address - Street 1:3525 BIENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5249
Mailing Address - Country:US
Mailing Address - Phone:504-279-6414
Mailing Address - Fax:504-277-1834
Practice Address - Street 1:1539 DELACHAISE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3513
Practice Address - Country:US
Practice Address - Phone:504-895-3953
Practice Address - Fax:504-896-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1518204Medicaid