MEDICARE: SILVERLEAF HEALTHCARE SYSTEMS INC

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	332B00000X	Durable Medical Equipment & Medical Supplies		TX

General Provider Information

NPI Number	:	1174694293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVERLEAF HEALTHCARE SYSTEMS INC

Provider Business Mailing Address
First Line	:	1201 N WATSON RD
Second Line	:	SUITE 220
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6190
Country	:	US
Telephone Number	:	817-633-7787
Fax Number	:	817-633-7781

Provider Business Practice Location Address
First Line	:	1201 N WATSON RD
Second Line	:	SUITE 220
City	:	ARLINGTON
State	:	TX
Zip	:	76006-6190
Country	:	US
Telephone Number	:	817-633-7787
Fax Number	:	817-633-7781

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ROSELYN A JACK SR.
Credential	:
Telephone Number	:	817-633-7787

Provider Enumeration Date	:	11/11/2006
Last Update Date	:	07/21/2022

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