Provider Demographics
NPI:1770047169
Name:SILVER CARE AGENCY LLC
Entity Type:Organization
Organization Name:SILVER CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
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 1:4 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1770 W COUNTY LINE ROAD
Practice Address - Street 2:STE 101
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-276-5828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SILVER CARE AGENCY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)