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General NPI Number Information
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NPI Number | 1245755651
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Entity Type | Organization
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Legal Business Name | SILVERCARE LLC
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 16880 KLAMATH TRL
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City | LAKEVILLE
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State | MN
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Zip | 55044-7939
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Country | US
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Telephone | 952-435-8002
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Fax | 952-435-4070
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Provider Business Mailing Address
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Address Line | 5402 PARKDALE DR STE 301
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-1604
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Country | US
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Telephone | 952-922-9540
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Fax | 952-922-9520
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | BRENDA BRIGGS
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Credential |
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Telephone | 952-922-9547
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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 | 381904
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License Number State | MN
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