MEDICARE: SILVER LINING RESIDENITAL CARE

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	310400000X	Assisted Living Facility	306005453	CA

General Provider Information

NPI Number	:	1245733526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER LINING RESIDENITAL CARE

Provider Business Mailing Address
First Line	:	PO BOX 2869
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92814-0869
Country	:	US
Telephone Number	:	949-682-5229
Fax Number	:

Provider Business Practice Location Address
First Line	:	1243 N BROOKHURST ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-1605
Country	:	US
Telephone Number	:	949-682-5229
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LACY FADDOUL
Credential	:
Telephone Number	:	949-682-5229

Provider Enumeration Date	:	03/13/2018
Last Update Date	:	09/24/2022

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