| Name: | SSC Montgomery South Haven Operating Company LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Withdrawn |
| Date of registration: | 28 Jul 2004 (20 years ago) (Companies founded in July 2004) |
| Entity Number: | 000-607-021 |
| Register Number: | 000607021 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 1209 ORANGE STWILMINGTON, DE 19801 |
| Registered Office Street Address: | 2 NORTH JACKSON ST., SUITE 605MONTGOMERY, AL 36104 |
Activities
SKILLED NURSING FACILITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942321872 | 2007-04-02 | 2015-11-04 | 5300 W SAM HOUSTON PKWY N, SUITE 100, HOUSTON, TX, 770415161, US | 1300 E SOUTH BLVD, MONTGOMERY, AL, 361162318, US | |||||||||||||||||||||||||
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| Phone | +1 832-467-6000 |
| Phone | +1 334-288-0122 |
Authorized person
| Name | KELLE C SANTORO |
| Role | SR DIRECTOR AR |
| Phone | 8324675728 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 12654 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4750430S |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6DNY8 | Obsolete | Non-Manufacturer | 2012-09-10 | 2022-11-11 | 2022-11-10 | No data | |||||||||||||||||||||||
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| POC | KELLE C SANTORO |
| Phone | +1 832-467-5794 |
| Fax | +1 832-467-8500 |
| Address | 1300 E SOUTH BLVD, MONTGOMERY, AL, 36116 2318, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | |
|---|---|
| Vendor Certified | 2017-11-09 |
| CAGE number | 79N14 |
| Company Name | SAVASENIORCARE LLC |
| CAGE Last Updated | 2023-06-20 |
| List of Offerors (0) | Information not Available |
|---|
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
