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General NPI Number Information
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NPI Number | 1538667720
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Entity Type | Organization
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Legal Business Name | SILVER CLOUD MANAGEMENT, LLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 315 N TAFFEE DR
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City | HASTINGS
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State | MI
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Zip | 49058-1175
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Country | US
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Telephone | 616-889-7340
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 WILLITS RD
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City | HASTINGS
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State | MI
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Zip | 49058-9514
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Country | US
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Telephone | 616-889-7340
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Fax | 231-953-1233
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Authorized Official
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Title or Position | MEMBER
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Name | MR. TIMOTHY YORK ADAMS
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Credential | MA
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Telephone | 616-889-7340
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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 | AS080387517
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License Number State | MI
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