Provider Demographics
NPI:1013391770
Name:SIVA ASSISTED LIVING SERVICES LTD CO
Entity Type:Organization
Organization Name:SIVA ASSISTED LIVING SERVICES LTD CO
Other - Org Name:SILVER RIDGE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADHAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MEKALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-514-3826
Mailing Address - Street 1:5314 BRANSFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3530
Mailing Address - Country:US
Mailing Address - Phone:817-514-3826
Mailing Address - Fax:817-886-2620
Practice Address - Street 1:5314 BRANSFORD RD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3530
Practice Address - Country:US
Practice Address - Phone:817-514-3826
Practice Address - Fax:817-886-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility