Provider Demographics
NPI:1811422389
Name:SILVER ALERT LLC
Entity Type:Organization
Organization Name:SILVER ALERT LLC
Other - Org Name:LAKE HENDON ESTATE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-721-2791
Mailing Address - Street 1:5311 CARSON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-7753
Mailing Address - Country:US
Mailing Address - Phone:407-891-2220
Mailing Address - Fax:
Practice Address - Street 1:5311 CARSON ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-7753
Practice Address - Country:US
Practice Address - Phone:407-891-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL129173104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL12917OtherAHCA