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General NPI Number Information
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NPI Number | 1831798289
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Entity Type | Organization
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Legal Business Name | SILOAM HEALTH CARE SERVICES
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Dates
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Enumeration Date | 10/17/2020
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Last Update Date | 10/17/2020
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Provider Practice Location Address
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Address Line | 1205 NEVILLE AVE
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City | LAKELAND
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State | FL
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Zip | 33805-4144
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Country | US
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Telephone | 863-510-5921
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 NEVILLE AVE
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City | LAKELAND
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State | FL
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Zip | 33805-4144
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Country | US
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Telephone | 863-510-5921
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | BERGELINE LEXIS
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Credential |
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Telephone | 323-705-8054
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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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