Basic Information
| Provider Information | |||||||||
| NPI: | 1487697017 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SSC EQUITY HOLDINGS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | ONE RAVINIA DRIVE, SUITE 1400 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708295100 | ||||||||
| FaxNumber: | 6784436778 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE RAVINIA DRIVE, SUITE 1400 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708295100 | ||||||||
| FaxNumber: | 6784436778 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 09/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | FORMAN | ||||||||
| AuthorizedOfficialFirstName: | MURRAY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BOD/OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7708295100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.