Provider Demographics
NPI:1790002574
Name:SILVERADO CORPORATION
Entity Type:Organization
Organization Name:SILVERADO CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-333-1511
Mailing Address - Street 1:4 CORNWALL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3332
Mailing Address - Country:US
Mailing Address - Phone:866-333-1511
Mailing Address - Fax:732-967-0095
Practice Address - Street 1:4 CORNWALL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3332
Practice Address - Country:US
Practice Address - Phone:866-333-1511
Practice Address - Fax:732-967-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0026100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health