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General NPI Number Information
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NPI Number | 1104113661
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Entity Type | Organization
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Legal Business Name | SILVER RIDGE INC
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 20332 HACKBERRY DR
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City | GRETNA
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State | NE
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Zip | 68028-4951
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Country | US
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Telephone | 402-332-4280
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Fax | 402-905-2319
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Provider Business Mailing Address
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Address Line | 20332 HACKBERRY DR
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City | GRETNA
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State | NE
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Zip | 68028-4951
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Country | US
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Telephone | 402-332-4280
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Fax | 402-905-2319
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAN SEDLACEK
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Credential |
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Telephone | 402-332-4280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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