Organization
SSC PUEBLO OPERATING COMPANY LLC
Active
Other names
Minnequa Medicenter
Organization subpart
No
Provider details
NPI number
Authorized official
KELLE C SANTORO (SR DIRECTOR AR)
(832) 467-5728
Entity
Organization
Contact information
Practice address
2701 CALIFORNIA ST, PUEBLO, CO 81004-3869
(719) 561-1300
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
0004
CO
385H00000X
Respite Care
0004
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01627015
—
CO
05
—
53273761
—
CO
Enumeration date
04/03/2007
Last updated
11/17/2020
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