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Organization

SSC MONTROSE SAN JUAN OPERATING COMPANY LLC

Active
Parent organization
SSC MONTROSE SAN JUAN OPERATING COMPANY LLC
Other names
San Juan Living Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
SSC MONTROSE SAN JUAN OPERATING COMPANY LLC
Authorized official
KEN PITTS (DIRECTOR REIMBURSEMENT SERVICES)
(832) 467-6793
Entity
Organization

Contact information

Practice address
1043 RIDGE ST, MONTROSE, CO 81401-4423
(970) 249-9683
Mailing address
5300 W SAM HOUSTON PKWY N STE 100, HOUSTON, TX 77041-5162
(862) 467-6000
(832) 467-8500

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
1300
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000160358
CO
Enumeration date
05/01/2018
Last updated
05/01/2018
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