Modern Senior Living LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MODERN SENIOR LIVING LLC

Doing business as

South Dallas Nursing and Rehabilitation

Practice address

3808 S Central Expy
Dallas, TX 75215-3701

Phone

(214) 428-5851

NPI assigned

Dec 28, 2010

Last updated

Jan 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Troy P IssacNPI 1891893988

Title

Manager

Phone

(972) 669-1243

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SOUTH DALLAS NURSING AND REHABILITATION Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346544855. Details of each certification follow.

• CCN 675440 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 675440

Legal name

MODERN SENIOR LIVING LLC

Doing business as

SOUTH DALLAS NURSING AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Jan 24, 1995

Last certification

Sep 10, 2024

Beds

91

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Mar 17, 2010 in TX

Enrollment address

3808 S Central Expy
Dallas, TX 75215-3701

Nursing home name

SOUTH DALLAS NURSING & REHABILITATION

Listed as

South Dallas Nursing & RehabilitationCCN 675440 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 24, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9172.8 residents per day on average

Penalties (3 years)

2Fines totaling $272,139

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Modern Senior Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• C F & H Corporation

  dba South Dallas Nursing Home

  • Skilled Nursing Facility
  • Dallas, TX
  • NPI 1376524850
  NPD tax ID

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jyotsna S Prasad, MD

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1477571883

  Adp of the SNF

  CMS ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Troy P Issac, TECH

  • Radiography Radiologic Technologist
  • Mesquite, TX
  • NPI 1891893988
  Authorized official Same address or phone
• Bassem Morad Mostafa Elsawy, MD, CMD, AGSF, FAAFP

  • Family Medicine Physician
  • Sunnyvale, TX
  • NPI 1629016159
  NPD (past)
• Jyotsna S Prasad, MD

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1477571883
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jyotsna S Prasad, MD

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1477571883

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1346544855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 GUS THOMASSON ROAD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "75150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 S CENTRAL EXPY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752153701",
            "telephone_number": "214-428-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "ISSAC",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-669-1243",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "675440",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4607",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH DALLAS NURSING AND REHABILITATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Dallas, TX
• Providers in Dallas, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.