Organization
SSC NEWPORT BEACH OPERATING COMPANY LP
Active
Other names
Flagship Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLE C SANTORO (SR DIRECTOR AR)
(832) 467-5728
Entity
Organization
Contact information
Practice address
466 FLAGSHIP RD, NEWPORT BEACH, CA 92663-3635
(949) 642-8044
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
060000154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZT05121I
PREVIOUS MEDICAID NUMBER
CA
05
—
ZZT05121J
—
CA
Enumeration date
03/30/2007
Last updated
11/17/2020
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