SSC Crete Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

674001 Issued in NE

Legal business name

SSC CRETE OPERATING COMPANY LLC

Doing business as

Crete Manor

Practice address

830 E 1St St
Crete, NE 68333-3108

Phone

(402) 826-4325

NPI assigned

Apr 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crete Manor Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1285755868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W SAM HOUSTON PKWY N",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415161",
            "telephone_number": "832-467-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 E 1ST ST",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683333108",
            "telephone_number": "402-826-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC CRETE OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "SANTORO",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR DIRECTOR AR",
        "authorized_official_telephone_number": "832-467-5728"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "674001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100252447-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crete Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fanny Smith
• Miranda L Smith
• Tyrone Smith
• Blaine Spanjer
• McKenna Squires
• Jasmine Steele
• Steven J Lehr
• Melissa Stewart
• Ann Renee Stokebrand, RN BSN
• Katherine Rachel Stranberg, L.M.H.P.

• Skilled Nursing Facility in Crete, NE
• Providers in Crete, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.