Healthcare Provider Details

I. General information

NPI: 1912611997
Provider Name (Legal Business Name): SILVER HOUSE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13507 N 145TH DR
SURPRISE AZ
85379-6162
US

IV. Provider business mailing address

13507 N 145TH DR
SURPRISE AZ
85379-6162
US

V. Phone/Fax

Practice location:
  • Phone: 202-681-1274
  • Fax:
Mailing address:
  • Phone: 202-681-1274
  • Fax: 480-607-7003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: REGINA JO JONES
Title or Position: OWNER, DIRECTOR
Credential: FNP
Phone: 602-510-4954