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General NPI Number Information
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NPI Number | 1568038214
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Entity Type | Organization
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Legal Business Name | SILVER LEAF ASSISTED LIVING LLC
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 4318 W CRAWFORD ST
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City | DENISON
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State | TX
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Zip | 75020-3829
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Country | US
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Telephone | 914-643-6335
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 LEGACY DR STE 2000
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City | FRISCO
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State | TX
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Zip | 75034-5992
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Country | US
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Telephone | 914-643-6335
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DAN BLACKBURN
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Credential |
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Telephone | 914-643-6335
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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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