Healthcare Provider Details

I. General information

NPI: 1427415280
Provider Name (Legal Business Name): SILVER CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2016
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MCKINLEY AVE
LAKEWOOD NJ
08701-2377
US

IV. Provider business mailing address

4 MCKINLEY AVE
LAKEWOOD NJ
08701-2377
US

V. Phone/Fax

Practice location:
  • Phone: 732-276-5828
  • Fax:
Mailing address:
  • Phone: 732-276-5828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number37PC00427700
License Number StateNJ

VIII. Authorized Official

Name: CHAVA ELLINSON
Title or Position: DIRECTOR
Credential: LPC
Phone: 732-276-5828