Provider Demographics
NPI:1346668811
Name:SILVER IMPACT, INC
Entity Type:Organization
Organization Name:SILVER IMPACT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ILLENE
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:954-572-0444
Mailing Address - Street 1:7155 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1038
Mailing Address - Country:US
Mailing Address - Phone:954-572-0444
Mailing Address - Fax:954-572-0092
Practice Address - Street 1:7155 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1038
Practice Address - Country:US
Practice Address - Phone:954-572-0444
Practice Address - Fax:954-572-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health