Healthcare Provider Details

I. General information

NPI: 1841311990
Provider Name (Legal Business Name): SILVER STREAM CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 PENLLYN PIKE
SPRING HOUSE PA
19477
US

IV. Provider business mailing address

310 S EASTON RD APT B406
GLENSIDE PA
19038-3927
US

V. Phone/Fax

Practice location:
  • Phone: 215-646-1500
  • Fax:
Mailing address:
  • Phone: 215-886-8098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberTE005792L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. LAUREN KARP
Title or Position: SENIOR PROGRAM MANAGER
Credential:
Phone: 215-646-1500