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NPI Code Detail

MEDICARE: SILVER CREEK HOME CARE INC.

MEDICARE: SILVER CREEK HOME CARE INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1311ZA0620XAdult Care Home Facility

General Provider Information

NPI Number : 1154180222
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVER CREEK HOME CARE INC.
Provider Business Mailing Address
First Line : 6530 BOON LAKE AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92119-2614
Country : US
Telephone Number : 619-464-3479
Fax Number :
Provider Business Practice Location Address
First Line : 6530 BOON LAKE AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92119-2614
Country : US
Telephone Number : 619-464-3479
Fax Number :
Authorized Official
Title or Position : ADMMINISTRATOR
Name : JULIET MENDOZA
Credential :
Telephone Number : 619-228-3331
Provider Enumeration Date : 03/18/2024
Last Update Date : 03/18/2024

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Directions to “SILVER CREEK HOME CARE INC. ” Practice Location

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