Provider Demographics
NPI:1659095024
Name:A SILVER LINING, LLC
Entity Type:Organization
Organization Name:A SILVER LINING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-594-6009
Mailing Address - Street 1:PO BOX 122
Mailing Address - Street 2:
Mailing Address - City:FALL ROCK
Mailing Address - State:KY
Mailing Address - Zip Code:40932-0122
Mailing Address - Country:US
Mailing Address - Phone:606-594-6009
Mailing Address - Fax:
Practice Address - Street 1:2051 LILY RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-9411
Practice Address - Country:US
Practice Address - Phone:606-280-4210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities