Provider Demographics
NPI:1700422953
Name:SILVER CARE AGENCY LLC
Entity Type:Organization
Organization Name:SILVER CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAVA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-276-5828
Mailing Address - Street 1:1770 W COUNTY LINE RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1176
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 E 13TH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1912
Practice Address - Country:US
Practice Address - Phone:732-276-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)