Provider Demographics
NPI:1508039702
Name:SILVER LINING YOUTH SERVICES, INC.
Entity Type:Organization
Organization Name:SILVER LINING YOUTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:VENABLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-767-6343
Mailing Address - Street 1:4894 DIPPEN RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-9711
Mailing Address - Country:US
Mailing Address - Phone:336-767-6343
Mailing Address - Fax:
Practice Address - Street 1:530 N SPRING ST
Practice Address - Street 2:UNIT C
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2729
Practice Address - Country:US
Practice Address - Phone:336-817-5029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health