SSC Lebanon Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

301 Issued in TN

Legal business name

SSC LEBANON OPERATING COMPANY LLC

Doing business as

Lebanon Health and Rehabilitation Center

Practice address

731 Castle Heights CT
Lebanon, TN 37087-2646

Phone

(615) 444-4319

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

• Lebanon Health and Rehabilitation Center 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": "1428969600000",
    "number": "1851412407",
    "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": "731 CASTLE HEIGHTS CT",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872646",
            "telephone_number": "615-444-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC LEBANON OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-04-14",
        "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": "TN",
            "license": "301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445268",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lebanon Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hardie V Sorrels IV, MD
• Hardie V Sorrels III, M.D.
• Southern Manor Living Centers of Lebanon, LLC
• Emily Spears
• Sydney Gabrielle Spurgeon, PA-C
• Michael E Staggs Jr., LPN
• Danielle Deslauriers Stamps, FNP
• Kimberly Staples, LMT
• Selena Starks
• Hannah Elaine Starr, LPC-MHSP (TEMP)

• Skilled Nursing Facility in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Skilled Nursing Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.