PECAN VALLEY SCC LLC (NPI# 1396124392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396124392 |
| Entity Type | Organization |
| Organization Name | PECAN VALLEY SCC LLC |
| Other Organization Name | SCC AT PECAN VALLEY REHABILITATION AND HEALTHCARE CENTER |
| Practice Address |
3838 E Southcross Blvd San Antonio TX 78222-3556 |
| Mailing Address |
600 N Pearl St Ste 1050 Dallas TX 75201-7495 |
| Practice Telephone | 2105816994 |
| Practice Fax Number | 2105726994 |
| Mailing Telephone | 2142527600 |
| Mailing Fax Number | 2142527599 |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | MICHAEL BEAL (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2142527600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | VENDOR ID/FACILITY ID | 5574/104259 | 01 |
| TX | 001027034 | 05 |
| Other Name | Type Code |
|---|---|
| SCC at Pecan Valley Rehabilitation and Healthcare Center | Doing Business As Name - Organization |
| Street Address |
3838 E SOUTHCROSS BLVD |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78222-3556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700111754 | Pecan Valley Healthcare LLC | Skilled Nursing Facility | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2009-10-08 |
| 1720632359 | Calavaras Creek Healthcare, Inc. | Skilled Nursing Facility | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2019-07-31 |
| 1316420185 | Jennifer Lynn Meave | Occupational Therapy Assistant | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2018-09-07 |
| 1922580315 | Desiree Yasmin Aguirre | Physical Therapy Assistant | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2018-08-31 |
| 1396226593 | Sheila M Maltos | Occupational Therapist | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2018-08-24 |
| 1306327895 | Paul Adams | Occupational Therapy Assistant | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2018-08-23 |
| 1750862348 | Ariel Cristin Benavides | Speech-Language Pathologist | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2018-08-22 |
| 1518447499 | Michael James Moriarty | Physical Therapy Assistant | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2018-08-20 |
| 1770063828 | Jacqueline Barrera | Physical Medicine & Rehabilitation | 3838 E Southcross Blvd, San Antonio, TX 78222-3556 | 2018-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285164897 | Kimberly Smith | Contractor | 2607 Lakebriar St, San Antonio, TX 78222 | 2017-06-15 |
| 1801045257 | Perly Lee Sheffield | Case Manager/Care Coordinator | 5518 Elk Hunter Tr., San Antonio, TX 78222 | 2008-09-10 |
| 1689822447 | James Edward Williams | Family Medicine | 3859 E Southcross Blvd Ste C, San Antonio, TX 78222 | 2008-09-05 |
| 1508025693 | Southcross Surgical Center, LLC | Clinic/Center | 4025 E. Southcross, Bldg 3 Ste. 15, San Antonio, TX 78222 | 2008-06-04 |
| 1184839235 | Michael C Key | Dentist | 3875 E Southcross, Ste F, San Antonio, TX 78222 | 2007-05-11 |
| 1245359017 | Celia S Faz | Home Health Aide | 5511 Firestar Trail, San Antonio, TX 78222 | 2007-03-29 |
| 1730272501 | Best Fit Prosthetics LLC | Durable Medical Equipment & Medical Supplies | 3859 E Southcross, Ste H, San Antonio, TX 78222 | 2006-10-02 |
| 1326150806 | Angela E Adams | Nurse Practitioner | 4243 E Southcross Blvd Ste 204, San Antonio, TX 78222 | 2006-08-31 |
| 1063435105 | Mark David Mutschink | Physical Therapist | 3875 E Southcross, Ste B, Ryke Physical Therapy & Sports Medicine, San Antonio, TX 78222 | 2006-07-26 |
| 1548210636 | Cameron Brent Elam | Physical Therapist | 3875 East Southcross, Ste B, Ryke Physical Therapy & Sports Medicine, San Antonio, TX 78222 | 2006-05-11 |
| Find all providers in zip 78222 | ||||
| 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 |
|---|---|---|---|---|
| 1780244533 | San Antonio Iv Enterprises, LLC | Skilled Nursing Facility | 5027 Pecan Grove Blvd, San Antonio, TX 78222-3529 | 2019-06-14 |
| 1558836379 | San Antonio Scc LLC | Skilled Nursing Facility | 6211 Old Pearsall Rd, San Antonio, TX 78242-2660 | 2018-10-08 |
| 1255858809 | Touchstone Strategies - Alamo LLC | Skilled Nursing Facility | 250 W Nottingham Dr Ste 200, San Antonio, TX 78209-1896 | 2017-08-24 |
| 1013452689 | Moc San Antonio II LLC | Skilled Nursing Facility | 6035 Eckhert Rd, San Antonio, TX 78240-3164 | 2017-01-05 |
| 1982050431 | Touchstone Strategies - Stone Oak2 LLC | Skilled Nursing Facility | 18803 Hardy Oak, San Antonio, TX 78258 | 2016-05-13 |
| 1811357155 | Dewitt Medical District | Skilled Nursing Facility | 222 Bertetti Dr, San Antonio, TX 78227-3950 | 2016-02-29 |
| 1659739696 | Westover Continuing Care Center Ltd. Co. | Skilled Nursing Facility | 11106 Christus Hills, San Antonio, TX 78251-3584 | 2016-02-05 |
| 1063881647 | Touchstone Strategies - Mc1 LLC | Skilled Nursing Facility | 250 W Nottingham Dr, Suite 200, San Antonio, TX 78209-1895 | 2015-09-24 |
| 1841676665 | Gruenepointe 1 River City, LLC | Skilled Nursing Facility | 921 Nolan St, San Antonio, TX 78202-2323 | 2015-08-04 |
| 1225413008 | Gruenepointe 1 Casa Rio, LLC | Skilled Nursing Facility | 6211 S New Braunfels Ave, San Antonio, TX 78223-3175 | 2015-07-22 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78222 |
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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.