Provider Demographics
NPI:1609034883
Name:SILVER LIGHTNING HOME HEALTH CARE, LLC.
Entity Type:Organization
Organization Name:SILVER LIGHTNING HOME HEALTH CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SERPOUHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-677-2220
Mailing Address - Street 1:2880 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1354
Mailing Address - Country:US
Mailing Address - Phone:954-677-2220
Mailing Address - Fax:954-677-2272
Practice Address - Street 1:2880 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 221
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1221
Practice Address - Country:US
Practice Address - Phone:954-677-2220
Practice Address - Fax:954-677-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-24
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992977251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health