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General NPI Number Information
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NPI Number | 1326243072
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Entity Type | Organization
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Legal Business Name | SSC NORTH DALLAS OPERATING COMPANY
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8383 MEADOW RD
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City | DALLAS
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State | TX
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Zip | 75231-3701
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Country | US
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Telephone | 214-369-7811
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RAVINIA DR SUITE 1400
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City | ATLANTA
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State | GA
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Zip | 30346-2112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EVP - COMPLIANCE AND AUDIT
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Name | MR. BRENT SNELGROVE
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Credential |
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Telephone | 678-443-6770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 008311
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License Number State | TX
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