Active NPI
SSC Montrose San Juan Operating Company LLC
Doing business as San Juan Living Center
- Respite Care
- Montrose, CO
National Provider Identifier
1932697380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Respite Care
- License
- 1300
- Legal business name
- SSC MONTROSE SAN JUAN OPERATING COMPANY LLC
- Doing business as
- San Juan Living Center
- Practice address
- 1043 Ridge St
Montrose, CO 81401-4423 - Phone
- (970) 249-9683
- NPI assigned
- May 1, 2018
- Organization subpart
- Yes
- Parent organization
- SSC MONTROSE SAN JUAN OPERATING COMPANY LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ken Pitts
- Title
- Director Reimbursement Services
- Phone
- (832) 467-6793
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | 1300 | CO | Primary |
Addresses
Primary practice location
1043 Ridge St
Montrose, CO 81401-4423
Mailing address
5300 W Sam Houston Pkwy N Ste 100
Houston, TX 77041-5162
Phone (862) 467-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000160358 | Medicaid | CO |
Other names 1
- San Juan Living Center
National Provider Directory
National Provider Directory- Part of
- SSC Montrose San Juan Operating Company LLC
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
dba San Juan Living Center
- Skilled Nursing Facility
- Montrose, CO
- NPI 1699895565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1525132800000",
"number": "1932697380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 W SAM HOUSTON PKWY N STE 100",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770415162",
"telephone_number": "862-467-6000",
"fax_number": "832-467-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1043 RIDGE ST",
"city": "MONTROSE",
"state": "CO",
"postal_code": "814014423",
"telephone_number": "970-249-9683"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SSC MONTROSE SAN JUAN OPERATING COMPANY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SSC MONTROSE SAN JUAN OPERATING COMPANY LLC",
"enumeration_date": "2018-05-01",
"last_updated": "2018-05-01",
"status": "A",
"authorized_official_last_name": "PITTS",
"authorized_official_first_name": "KEN",
"authorized_official_title_or_position": "DIRECTOR REIMBURSEMENT SERVICES",
"authorized_official_telephone_number": "832-467-6793"
},
"taxonomies": [
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "CO",
"license": "1300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000160358",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "San Juan Living Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "San Juan Living Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Montrose, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.