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Organization
SSC STATESVILLE MAPLE LEAF OPERATING COMPANY LLC
Active
Organization
SSC STATESVILLE MAPLE LEAF OPERATING COMPANY LLC
Active
Other names
Maple Leaf Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
KELLE C SANTORO (SR DIRECTOR AR)
(832) 467-5728
Entity
Organization
Contact information
Practice address
1101 MAPLE CARE LANE, STATESVILLE, NC 28625-8256
(704) 871-0705
Mailing address
5300 W SAM HOUSTON PKWY N, SUITE 100, HOUSTON, TX 77041-5161
(832) 467-6000
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
NH0488
NC
311ZA0620X
Adult Care Home Facility
NH0488
NC
313M00000X
Nursing Facility/Intermediate Care Facility
NH0488
NC
314000000X
Skilled Nursing Facility
Primary
NH0488
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3425340
—
NC
05
—
3426265
—
NC
05
—
7801592
—
NC
Enumeration date
03/31/2007
Last updated
11/17/2020
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