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General NPI Number Information
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NPI Number | 1750704573
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Entity Type | Organization
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Legal Business Name | SILVER SENIOR HEALTH CARE
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Dates
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Enumeration Date | 01/30/2014
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 4439 DEVILS GLEN RD UNIT 123
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City | BETTENDORF
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State | IA
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Zip | 52722-8401
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Country | US
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Telephone | 563-370-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 4439 DEVILS GLEN RD UNIT 123
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City | BETTENDORF
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State | IA
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Zip | 52722-8404
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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 | PRESIDENT-RN
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Name | STACY SIMON-LEE
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Credential | RN
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Telephone | 56337003800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 121791
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 041369832
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 04136832
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 121791
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License Number State | IA
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