Healthcare Provider Details

I. General information

NPI: 1356052187
Provider Name (Legal Business Name): SILVER SERVANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E FOOTHILL BLVD
POMONA CA
91767-1405
US

IV. Provider business mailing address

333 E FOOTHILL BLVD
POMONA CA
91767-1405
US

V. Phone/Fax

Practice location:
  • Phone: 626-850-0101
  • Fax: 626-850-0104
Mailing address:
  • Phone: 626-850-0101
  • Fax: 626-850-0104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE FELIX
Title or Position: HHO ADMIN
Credential:
Phone: 626-850-0101