BOSSIER SCC LLC (NPI# 1851772610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851772610 |
| Entity Type | Organization |
| Organization Name | BOSSIER SCC LLC |
| Other Organization Name | SCC OF PILGRIM MANOR REHABILITATION CENTER |
| Practice Address |
1524 Doctors Dr Bossier City LA 71111-3322 |
| Mailing Address |
600 N Pearl St Ste 1100 Dallas TX 75201-7495 |
| Practice Telephone | 3187421623 |
| Practice Fax Number | 3187422878 |
| Mailing Telephone | 2142527600 |
| Mailing Fax Number | 2142527704 |
| Enumeration Date | 2015-06-17 |
| 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 | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | MEDICARE PART A | 19-5594 | 01 |
| LA | 1510696 | 05 |
| Other Name | Type Code |
|---|---|
| SCC of Pilgrim Manor Rehabilitation Center | Doing Business As Name - Organization |
| Street Address |
1524 DOCTORS DR |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71111-3322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063454338 | Pilgrim Manor Guest Care Center, LLC | Skilled Nursing Facility | 1524 Doctors Dr, Bossier City, LA 71111-3322 | 2006-06-12 |
| 1669933081 | Pmg Opco-pilgrim LLC | Skilled Nursing Facility | 1524 Doctors Dr, Bossier City, LA 71111-3322 | 2019-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669007951 | Tamara 'tammy' Larck | Counselor | 1525 Fullilove Drive, Shreveport, LA 71111 | 2020-03-06 |
| 1912538315 | Lagniappe Chiropractic | Chiropractor | 2400 Airline Drive, Bossier City, LA 71111 | 2020-02-04 |
| 1649817420 | Lifecare Medical Transportation, LLC. | Non-emergency Medical Transport (VAN) | 25 Duck Haven Pointe, Bossier City, LA 71111 | 2019-11-29 |
| 1770126344 | Bertresea White Evans | Nurse Practitioner | Coastal Urgernt Care, 5314 Airline Drive, Bossier City, LA 71111 | 2019-10-25 |
| 1861964058 | Erika Davis Reed | Counselor | 1515 Doctors Dr # 16, Bossier City, LA 71111 | 2018-12-28 |
| 1518436898 | Charlotte Mckay | Case Manager/Care Coordinator | 31330 Hwy 22, Ste 101, Bossier City, LA 71111 | 2018-11-16 |
| 1992271464 | Np2u, LLC | Nurse Practitioner | 2008 Airline Drive Suite 300 #194, Bossier City, LA 71111 | 2018-10-22 |
| 1114416542 | Lashaunda Autrey | Counselor | 410 Half Moon Lane, Bossier, LA 71111 | 2018-05-01 |
| 1750887196 | Shenya Williams-pennywell | Counselor | 1007 Gould Drive Bldg 2, Suite 1, Bossier City, LA 71111 | 2018-04-04 |
| 1336647304 | Patrick Vance | Physical Therapist | 5000 Benton Rd Ste 1, Bossier City, LA 71111 | 2018-01-24 |
| Find all providers in zip 71111 | ||||
| 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 |
|---|---|---|---|---|
| 1073884300 | Leah Rhea Curlis | Skilled Nursing Facility | 6015 Braeburn Ct, Bossier City, LA 71111-5748 | 2012-01-18 |
| 1902955636 | Nw La War Veterans Home | Skilled Nursing Facility | 3130 Arthur Ray Teague Parkway, Bossier City, LA 71112 | 2007-01-10 |
| 1063454338 | Pilgrim Manor Guest Care Center, LLC | Skilled Nursing Facility | 1524 Doctors Dr, Bossier City, LA 71111-3322 | 2006-06-12 |
| 1518909886 | Colonial Oaks Guest Care Center, LLC | Skilled Nursing Facility | 4921 Medical Dr, Bossier City, LA 71112-4522 | 2006-06-12 |
| 1386682359 | Red River Center LLC | Skilled Nursing Facility | 4820 Medical Dr, Bossier City, LA 71112-4562 | 2006-06-03 |
| 1639126873 | Bossier Healthcare LLC | Skilled Nursing Facility | 2575 Airline Dr, Bossier City, LA 71111-5812 | 2006-05-30 |
| 1467409805 | Garden Court Healthcare LLC | Skilled Nursing Facility | 4405 Airline Dr, Bossier City, LA 71111-2058 | 2006-05-30 |
| 1851372973 | Cypress Point Nursing & Rehabilitation Center, LLC | Skilled Nursing Facility | 2901 Douglas Dr, Bossier City, LA 71111-5807 | 2005-11-07 |
| 1124589544 | Pmg Opco-colonial LLC | Skilled Nursing Facility | 4921 Medical Dr, Bossier City, LA 71112-4522 | 2019-03-28 |
| 1669933081 | Pmg Opco-pilgrim LLC | Skilled Nursing Facility | 1524 Doctors Dr, Bossier City, LA 71111-3322 | 2019-03-28 |
| Find all providers in BOSSIER CITY | ||||
| City | BOSSIER CITY |
| Zip Code | 71111 |
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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.