Provider Demographics
NPI:1487697017
Name:SSC EQUITY HOLDINGS LLC
Entity type:Organization
Organization Name:SSC EQUITY HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOD/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-829-5100
Mailing Address - Street 1:ONE RAVINIA DRIVE, SUITE 1400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346
Mailing Address - Country:US
Mailing Address - Phone:770-829-5100
Mailing Address - Fax:678-443-6778
Practice Address - Street 1:ONE RAVINIA DRIVE, SUITE 1400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346
Practice Address - Country:US
Practice Address - Phone:770-829-5100
Practice Address - Fax:678-443-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE219023Medicare ID - Type UnspecifiedMEDICARE NUMBER