MEDICARE: SILVER CARE AGENCY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1053957209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	1770 W COUNTY LINE RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1175
Country	:	US
Telephone Number	:	732-276-5828
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 KENT RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1172
Country	:	US
Telephone Number	:	732-276-5828
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CHAVA E ELLINSON
Credential	:
Telephone Number	:	732-276-5828

Provider Enumeration Date	:	11/22/2019
Last Update Date	:	11/22/2019

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Directions to “SILVER CARE AGENCY LLC ” Practice Location

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