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NPI Code Detail

MEDICARE: SILVER RIDGE MANAGEMENT INC

MEDICARE: SILVER RIDGE MANAGEMENT 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
1314000000XSkilled Nursing FacilityNCI-2664AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437270634
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVER RIDGE MANAGEMENT INC
Provider Business Mailing Address
First Line : 2812 SILVER CREEK RD
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-8309
Country : US
Telephone Number : 928-763-1404
Fax Number : 928-763-9795
Provider Business Practice Location Address
First Line : 2812 SILVER CREEK RD
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-8309
Country : US
Telephone Number : 928-763-1404
Fax Number : 928-763-9795
Authorized Official
Title or Position : CEO
Name : DEAN CHARLES KIDDER
Credential :
Telephone Number : 928-718-4852
Provider Enumeration Date : 04/03/2007
Last Update Date : 02/18/2011

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Directions to “SILVER RIDGE MANAGEMENT INC ” Practice Location

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