SSC Montgomery South Haven Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

12654 Issued in AL

Legal business name

SSC MONTGOMERY SOUTH HAVEN OPERATING COMPANY LLC

Practice address

1300 E South Blvd
Montgomery, AL 36116-2318

Phone

(334) 288-0122

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

• South Haven Health and Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1942321872",
    "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": "1300 E SOUTH BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162318",
            "telephone_number": "334-288-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSC MONTGOMERY SOUTH HAVEN OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-11-04",
        "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": "12654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4750430S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Haven Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karla Spratlan, PHARMD
• Kristi Springer, CRNP
• Courtney Sprinkle, PT, DPT
• Keerthi Venkata Sreeramoju, MD
• SSC Montgomery Cedar Crest Operating Company LLC
• SSC Montgomery Woodley Manor Opr Co. LLC
• Johanna Marie St Bernard
• Luther St James IV, M.D.
• St. Jude Catholic Hospital
• Laura Jenelle Stabin, M.D.

• All providers in Montgomery, AL
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.