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General NPI Number Information
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NPI Number | 1154180222
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Entity Type | Organization
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Legal Business Name | SILVER CREEK HOME CARE INC.
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 6530 BOON LAKE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92119-2614
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Country | US
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Telephone | 619-464-3479
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Fax |
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Provider Business Mailing Address
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Address Line | 6530 BOON LAKE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92119-2614
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Country | US
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Telephone | 619-464-3479
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Fax |
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Authorized Official
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Title or Position | ADMMINISTRATOR
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Name | JULIET MENDOZA
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Credential |
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Telephone | 619-228-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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