# SSC HOUSTON NORTHWEST OPERATING COMPANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwest Health and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114048683
- **Authorized official:** KELLE C SANTORO (SR DIRECTOR AR)
- **Authorized official phone:** (832) 467-5728

## Contact information

- **Practice address:** 17600 CALI DR, HOUSTON, TX 77090-2703
- **Practice address phone:** (281) 440-9000
- **Mailing address:** 5300 W SAM HOUSTON PKWY N, SUITE 100, HOUSTON, TX 77041-5161
- **Mailing address phone:** (832) 467-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 116324 | TX | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 11/16/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000513704 | PREVIOUS MEDICAID NUMBER | — |
| 05 | — | 001013873 | — | TX |