Provider Demographics
NPI:1750704573
Name:SILVER SENIOR HEALTH CARE
Entity type:Organization
Organization Name:SILVER SENIOR HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-RN
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON-LEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:5633-700-3800
Mailing Address - Street 1:4439 DEVILS GLEN RD UNIT 123
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-8404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4439 DEVILS GLEN RD
Practice Address - Street 2:UNIT 123
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-8401
Practice Address - Country:US
Practice Address - Phone:563-370-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA121791251E00000X, 251G00000X
IL041369832251G00000X
IL04136832251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care