SSC Selma Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12524 Issued in AL

Legal business name

SSC SELMA OPERATING COMPANY LLC

Doing business as

Warren Manor Health and Rehabilitation Center

Practice address

11 Bell Rd
Selma, AL 36701-6793

Phone

(334) 874-7425

NPI assigned

Apr 2, 2007

Last updated

Apr 9, 2015By 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

Kelle C Santoro

Title

Sr Director Ar

Phone

(832) 467-5728

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Warren Manor 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": "1428537600000",
    "number": "1851412787",
    "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": "11 BELL RD",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016793",
            "telephone_number": "334-874-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC SELMA OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-04-09",
        "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": "AL",
            "license": "12524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4754280S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warren Manor Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rose Smith
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• Dae Y Song, M.D.
• State of Alabama
• State of Alabama Department of Public Health (Dallas County Home Care)
• State of Alabama Department of Public Health (Dallas County Home Care)
• State of Alabama Department of Public Health (Dallas County Home Care)
• State of Alabama Department of Public Health (Dallas County Health Dept Flu-Pneu)

• Skilled Nursing Facility in Selma, AL
• Providers in Selma, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.