Provider Demographics
NPI: | 1376093773 |
---|---|
Name: | SILVERSTONE HARBORCHASE PLANO OPERATING, LLC |
Entity Type: | Organization |
Organization Name: | SILVERSTONE HARBORCHASE PLANO OPERATING, LLC |
Other - Org Name: | HARBORCHASE OF PLANO |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CFO OF MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | THOMAS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MITCHELL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 772-492-5002 |
Mailing Address - Street 1: | 1440 HIGHWAY A1A |
Mailing Address - Street 2: | |
Mailing Address - City: | VERO BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32963-2310 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 772-492-5002 |
Mailing Address - Fax: | 772-492-5005 |
Practice Address - Street 1: | 5340 TOWNE SQUARE DR |
Practice Address - Street 2: | |
Practice Address - City: | PLANO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75024-2253 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-362-1110 |
Practice Address - Fax: | 972-362-1109 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-10-10 |
Last Update Date: | 2016-10-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |