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General NPI Number Information
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NPI Number | 1225704182
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Entity Type | Organization
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Legal Business Name | SILVER PINES LLC
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 16175 MEREDITH CT
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City | LINDEN
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State | MI
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Zip | 48451-9095
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Country | US
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Telephone | 810-399-7299
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Fax |
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Provider Business Mailing Address
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Address Line | 16175 MEREDITH CT
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City | LINDEN
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State | MI
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Zip | 48451-9095
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Country | US
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Telephone | 181-039-9729
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Fax |
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Authorized Official
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Title or Position | IT DIRECTOR
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Name | MR. MATT W MCCORMICK
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Credential |
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Telephone | 810-399-7299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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