NPIMap

Organization Active NPI

SNH SE Tenant TRS, Inc

Doing business as Cameron Hall - Canton

  • Assisted Living Facility
  • Canton, GA
National Provider Identifier
1780313841
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SNH SE TENANT TRS, INC
Doing business as
Cameron Hall - Canton
Practice address
240 Marietta Hwy
Canton, GA 30114-2311
Phone
(770) 720-0290
Fax
(770) 720-0289
NPI assigned
Jun 6, 2022
Last updated
Jun 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Authorized official

Name
Richard W. Siedel Jr.
Title
Cfo & Treasurer
Phone
(617) 796-8350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

240 Marietta Hwy
Canton, GA 30114-2311

Mailing address

240 Marietta Hwy
Canton, GA 30114-2311
Phone (770) 720-0290

Other names 1

  • Cameron Hall - Canton Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2074645Cameron Hall of Canton240 Marietta Highway, Canton, GA 30114Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
SNH SE Tenant TRS Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

240 Marietta Hwy
Canton, GA 30114
Phone (770) 720-0290

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1780313841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MARIETTA HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142311",
            "telephone_number": "770-720-0290",
            "fax_number": "770-720-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MARIETTA HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142311",
            "telephone_number": "770-720-0290",
            "fax_number": "770-720-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH SE TENANT TRS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "SIEDEL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CFO & TREASURER",
        "authorized_official_telephone_number": "617-796-8350",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cameron Hall - Canton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.