Provider Demographics
NPI:1609642453
Name:SILVER SPRINGS SENIOR SERVICES
Entity Type:Organization
Organization Name:SILVER SPRINGS SENIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKBURN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:828-260-1320
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:LINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28646-0374
Mailing Address - Country:US
Mailing Address - Phone:828-260-1320
Mailing Address - Fax:
Practice Address - Street 1:412 PINEOLA ST
Practice Address - Street 2:
Practice Address - City:NEWLAND
Practice Address - State:NC
Practice Address - Zip Code:28657-7603
Practice Address - Country:US
Practice Address - Phone:828-260-1320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty