SSC Kenansville Operating Company LLC
Organization Active NPI Skilled Nursing Facility · Kenansville, NC
NPI 1689777971 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1689777971
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NH0308 (NC)
- Legal business name
- SSC KENANSVILLE OPERATING COMPANY LLC
- Practice address
- 209 Beasley Street
Kenansville, NC 28349 - Phone
- (910) 296-1561
- Fax
- (910) 296-1016
- NPI assigned
- Sep 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Thomas Simons
- Title
- SVP Operations Finance
- Phone
- (678) 443-7000
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Kindred Nursing Centers East LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH0308 | NC | Yes |
Addresses
Primary practice location
209 Beasley Street
Kenansville, NC 28349
Mailing address
5300 W Sam Houston Pkwy N
Suite 100
Houston, TX 77041-5161
Phone (832) 467-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3445150 | Medicaid | NC |
Other names
- Kenansville Health and Rehabilitation Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc |
Other providers in Kenansville, NC
- Andrew Warren Simpson
- Skill Creations Inc
- Karen Smack
- Candace Deann Smith
- Curtis O. Smith
- Stevens Healthcare Agency, Inc.
- Veronica Frederick Stevens
- Kelly Stone
- Zachary Glenn Sutton
- Constance R Tambakis-Odom
All providers in Kenansville, NC · Skilled Nursing Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.