Healthcare Provider Details

I. General information

NPI: 1659207041
Provider Name (Legal Business Name): SILVERLIGHTCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17026 SHERMAN WAY
VAN NUYS CA
91406-3615
US

IV. Provider business mailing address

17026 SHERMAN WAY
VAN NUYS CA
91406-3615
US

V. Phone/Fax

Practice location:
  • Phone: 747-228-4111
  • Fax: 747-444-4031
Mailing address:
  • Phone: 747-228-4111
  • Fax: 747-444-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State

VIII. Authorized Official

Name: ELBA ALBERTOVNA KHACHATRYAN
Title or Position: AM
Credential:
Phone: 747-228-4111