Provider Demographics
NPI:1245755651
Name:SILVERCARE LLC
Entity Type:Organization
Organization Name:SILVERCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-922-9547
Mailing Address - Street 1:5402 PARKDALE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1604
Mailing Address - Country:US
Mailing Address - Phone:952-922-9540
Mailing Address - Fax:952-922-9520
Practice Address - Street 1:16880 KLAMATH TRL
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-7939
Practice Address - Country:US
Practice Address - Phone:952-435-8002
Practice Address - Fax:952-435-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN381904310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
681673OtherAVAILITY CUSTOMER ID