Healthcare Provider Details

I. General information

NPI: 1871613737
Provider Name (Legal Business Name): SSC WINDSOR OPERATING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2007
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 3RD ST
WINDSOR CO
80550-5484
US

IV. Provider business mailing address

5300 W SAM HOUSTON PKWY N SUITE 100
HOUSTON TX
77041-5161
US

V. Phone/Fax

Practice location:
  • Phone: 970-686-7474
  • Fax:
Mailing address:
  • Phone: 770-829-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number0074
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0074
License Number StateCO

VIII. Authorized Official

Name: KELLE C SANTORO
Title or Position: SR DIRECTOR AR
Credential:
Phone: 832-467-5728