Healthcare Provider Details

I. General information

NPI: 1659608768
Provider Name (Legal Business Name): SILVER HEARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2009
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7844 N ACADEMY BLVD
COLORADO SPRINGS CO
80920
US

IV. Provider business mailing address

7844 N ACADEMY BLVD
COLORADO SPRINGS CO
80920
US

V. Phone/Fax

Practice location:
  • Phone: 719-434-1002
  • Fax:
Mailing address:
  • Phone: 719-734-1002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICCOLE TODD
Title or Position: OWNER
Credential: LPN
Phone: 719-434-1002