Provider Demographics
NPI:1659516532
Name:HG SCC LLC
Entity Type:Organization
Organization Name:HG SCC LLC
Other - Org Name:HONEY GROVE NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-436-4343
Mailing Address - Street 1:1303 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HONEY GROVE
Mailing Address - State:TX
Mailing Address - Zip Code:75446-1268
Mailing Address - Country:US
Mailing Address - Phone:903-378-2293
Mailing Address - Fax:903-378-2503
Practice Address - Street 1:1303 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HONEY GROVE
Practice Address - State:TX
Practice Address - Zip Code:75446-1268
Practice Address - Country:US
Practice Address - Phone:903-378-2293
Practice Address - Fax:903-378-2503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127274314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001016966Medicaid
TX004858OtherFACILITY ID NO.
TX6274060001Medicare NSC
TX004858OtherFACILITY ID NO.