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General NPI Number Information
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NPI Number | 1407527765
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Entity Type | Organization
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Legal Business Name | SILVER PINES CARE HOME II, LLC
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 09/25/2021
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Provider Practice Location Address
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Address Line | 8717 VALLEY OAK LN
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City | ELK GROVE
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State | CA
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Zip | 95624-2522
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Country | US
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Telephone | 916-685-5101
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Fax |
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Provider Business Mailing Address
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Address Line | 9369 PORTO ROSA DR
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City | ELK GROVE
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State | CA
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Zip | 95624-2162
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Country | US
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Telephone | 916-308-2968
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Fax | 916-686-0608
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | DEBBIE LOESCH
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Credential | LVN
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Telephone | 916-308-2968
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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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