MEDICARE: SILVER CREEK HOSPICE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1568278844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER CREEK HOSPICE LLC

Provider Business Mailing Address
First Line	:	5613 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-2322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 SPRING MOUNTAIN RD STE 72
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8626
Country	:	US
Telephone Number	:	323-423-9950
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHEILA ANTOLIN
Credential	:	RN
Telephone Number	:	323-423-9950

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/10/2024

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