SSC FENTON OPERATING COMPANY LLC (NPI# 1124061353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124061353 |
| Entity Type | Organization |
| Organization Name | SSC FENTON OPERATING COMPANY LLC |
| Other Organization Name | CRESTMONT HEALTHCARE CENTER |
| Practice Address |
111 Trealout Dr Fenton MI 48430-1481 |
| Mailing Address |
5300 W Sam Houston Pkwy N Suite 100 Houston TX 77041-5161 |
| Practice Telephone | 8106294105 |
| Practice Fax Number | 8106297538 |
| Mailing Telephone | 8324676000 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2015-04-10 |
| Authorized Official Name | KELLE C SANTORO (SR DIRECTOR AR) |
| Authorized Official Telephone | 8324675728 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 254210 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4882204 | 05 |
| Other Name | Type Code |
|---|---|
| Crestmont Healthcare Center | Doing Business As Name - Organization |
| Street Address |
111 TREALOUT DR |
| City | FENTON |
| State | MI |
| Zip Code | 48430-1481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184274789 | Vickie Lee Woodbeck | Physical Therapy Assistant | 111 Trealout Dr, Fenton, MI 48430-1481 | 2019-09-16 |
| 1790938132 | Continuum Psychiatric Services LLP | Psychologist | 111 Trealout Dr, Fenton, MI 48430-1481 | 2008-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1164756425 | Cynthia Ann Babcock | Skilled Nursing Facility | 1167 Winter Park Dr, Fenton, MO 63026-5696 | 2009-09-18 |
| 1821258443 | Cori Manor Healthcare & Rehabilitation Center, LLC | Skilled Nursing Facility | 560 Corisande Hills Rd, Fenton, MO 63026-5613 | 2008-06-17 |
| 1346369261 | Supplemental Heath Care | Skilled Nursing Facility | 1520 Legacy Cir, Fenton, MO 63026-2378 | 2007-03-29 |
| 1114974391 | Fenton Healthcare LLC | Skilled Nursing Facility | 512 Beach St, Fenton, MI 48430-3122 | 2006-05-31 |
| 1013903525 | Delmar Gardens of Meramec Valley Operating, LLC | Skilled Nursing Facility | 1 Arbor Ter, Fenton, MO 63026-3900 | 2005-09-21 |
| 1689669665 | Cori Manor Nursing Home | Skilled Nursing Facility | 560 Corisande Hill Rd, Fenton, MO 63026-5613 | 2005-09-15 |
| 1679654420 | Mid Ameriaca Health Care | Skilled Nursing Facility | 1749 Gilsinn Ln, Fenton, MO 63026-2003 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538798731 | Windemere Park of Troy Operations LLC | Skilled Nursing Facility | 5990 N Adams Rd, Troy, MI 48098-2377 | 2020-04-08 |
| 1982235396 | Berg-lahser Snf, LLC | Skilled Nursing Facility | 21630 Hessel Ave # 1230, Detroit, MI 48219-1230 | 2020-02-04 |
| 1508497918 | Harmony Village Snf, LLC | Skilled Nursing Facility | 16588 Schaefer Hwy # 4249, Detroit, MI 48235-4249 | 2020-02-04 |
| 1336795244 | Ishpeming Nursing & Rehab Center, LLC | Skilled Nursing Facility | 435 Rd Pl, Ishpeming, MI 49849 | 2019-08-15 |
| 1669965299 | Wellbridge of Clarkston, LLC | Skilled Nursing Facility | 5655 Clarkston Road, Independence Township, MI 48348 | 2018-06-08 |
| 1104318112 | Wellbridge At Genesys Health Park, LLC | Skilled Nursing Facility | 3139 East Baldwin Road, Grand Blanc, MI 48439 | 2018-06-05 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1972092344 | Regency At Grand Haven, LLC | Skilled Nursing Facility | 17049 Comstock St, Grand Haven, MI 49417-7903 | 2018-05-01 |
| 1093214173 | Sana Nasir Inc. | Skilled Nursing Facility | 13840 King Rd, Riverview, MI 48193 | 2018-02-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.