Organization
SSC PUEBLO OPERATING COMPANY LLC
Active
Parent organization
SSC PUEBLO OPERATING COMPANY LLC
Other names
Minnequa Medicenter
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSC PUEBLO OPERATING COMPANY LLC
Authorized official
KEN PITTS (DIRECTOR REIMBURSEMENT)
(832) 467-6793
Entity
Organization
Contact information
Practice address
2701 CALIFORNIA ST, PUEBLO, CO 81004-3869
(719) 561-1300
Mailing address
5300 W SAM HOUSTON PKWY N STE 100, HOUSTON, TX 77041-5162
(832) 467-6000
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
0004
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000160668
—
CO
Enumeration date
05/21/2018
Last updated
05/21/2018
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