Healthcare Provider Details

I. General information

NPI: 1144938507
Provider Name (Legal Business Name): SILVER LIGHT ADULT DAY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3224 W 65TH ST
CLEVELAND OH
44102-5510
US

IV. Provider business mailing address

8302 JEFFRIES AVE
CLEVELAND OH
44105-6563
US

V. Phone/Fax

Practice location:
  • Phone: 216-235-3952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JAMILYA NEWELL
Title or Position: OWNER
Credential:
Phone: 216-235-3952