Provider Demographics
NPI:1659644185
Name:SCC PARTNERS, INC.
Entity Type:Organization
Organization Name:SCC PARTNERS, INC.
Other - Org Name:SENIOR CARE HEALTH AND REHABILITATION - BRIDGEPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-303-7500
Mailing Address - Street 1:1413 E I 30
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-4784
Mailing Address - Country:US
Mailing Address - Phone:972-303-7500
Mailing Address - Fax:972-303-9700
Practice Address - Street 1:2108 15TH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:TX
Practice Address - Zip Code:76426-2055
Practice Address - Country:US
Practice Address - Phone:940-683-5023
Practice Address - Fax:940-683-3184
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCC HEALTHCARE GROUP, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-14
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001017174Medicaid
TX675891Medicare Oscar/Certification