Provider Demographics
NPI:1780810234
Name:SCC PARTNERS INC
Entity type:Organization
Organization Name:SCC PARTNERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:DELBERT
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-303-7500
Mailing Address - Street 1:1413 E I30
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043
Mailing Address - Country:US
Mailing Address - Phone:972-303-7515
Mailing Address - Fax:972-303-9992
Practice Address - Street 1:2108 15TH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:TX
Practice Address - Zip Code:76426
Practice Address - Country:US
Practice Address - Phone:940-683-5023
Practice Address - Fax:940-683-3184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005260OtherFACILITY ID
TX001017174Medicaid
TX005260OtherFACILITY ID