MEDICARE: SSC LITTLETON OPERATING COMPANY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	0341	CO

General Provider Information

NPI Number	:	1912028770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SSC LITTLETON OPERATING COMPANY LLC

Provider Business Mailing Address
First Line	:	5300 W SAM HOUSTON PKWY N
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77041-5161
Country	:	US
Telephone Number	:	832-467-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6005 S HOLLY ST
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80121-3460
Country	:	US
Telephone Number	:	303-773-1000
Fax Number	:

Authorized Official
Title or Position	:	SR DIRECTOR AR
Name	:	KELLE C SANTORO
Credential	:
Telephone Number	:	832-467-5728

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	04/09/2015

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