Organization
SSC MONTGOMERY CEDAR CREST OPERATING COMPANY LLC
Active
Other names
Cedar Crest
Organization subpart
No
Provider details
NPI number
Authorized official
KELLE C SANTORO (SR DIRECTOR AR)
(832) 467-5728
Entity
Organization
Contact information
Practice address
4490 VIRGINIA LOOP RD, MONTGOMERY, AL 36116-3448
(334) 281-6826
Mailing address
5300 W SAM HOUSTON PKWY N, SUITE 100, HOUSTON, TX 77041-5161
(832) 467-6000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
12650
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4757180S
—
AL
Enumeration date
03/30/2007
Last updated
11/04/2015
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