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General NPI Number Information
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NPI Number | 1538509054
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Entity Type | Organization
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Legal Business Name | SILVER CREEK AL LLC
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 1300 SILVER CREEK AZLE RD
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City | AZLE
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State | TX
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Zip | 76020-3844
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Country | US
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Telephone | 817-238-8126
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 E HEBRON PKWY STE 100C
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City | CARROLLTON
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State | TX
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Zip | 75010-4468
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MITESH PATEL
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Credential |
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Telephone | 832-385-2295
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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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