Provider Demographics
NPI:1821470436
Name:SILEX RESIDENTIAL HOME LLC
Entity Type:Organization
Organization Name:SILEX RESIDENTIAL HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-384-5213
Mailing Address - Street 1:145 DUNCAN MANSION DR
Mailing Address - Street 2:
Mailing Address - City:SILEX
Mailing Address - State:MO
Mailing Address - Zip Code:63377-2229
Mailing Address - Country:US
Mailing Address - Phone:573-384-5213
Mailing Address - Fax:573-384-5209
Practice Address - Street 1:145 DUNCAN MANSION DR
Practice Address - Street 2:
Practice Address - City:SILEX
Practice Address - State:MO
Practice Address - Zip Code:63377-2229
Practice Address - Country:US
Practice Address - Phone:573-384-5213
Practice Address - Fax:573-384-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility