# SSC NUECES RETAMA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Retama Manor Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518036987
- **Authorized official:** KELLE C SANTORO (SENIOR DIRECTOR ACCOUNTS RECIEVABLE)
- **Authorized official phone:** (832) 467-5728

## Contact information

- **Practice address:** 2322 MORGAN AVE, CORPUS CHRISTI, TX 78405-1947
- **Practice address phone:** (361) 882-4242
- **Practice address fax:** (361) 883-3726
- **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 | 118447 | TX | Yes |
| 314000000X | Skilled Nursing Facility | — | — | — |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 11/17/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001014485 | — | TX |