Provider Demographics
NPI:1891147831
Name:SILVER TREE HOME CARE
Entity Type:Organization
Organization Name:SILVER TREE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JESEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-240-6464
Mailing Address - Street 1:10608 WATTERSON CENTER CT
Mailing Address - Street 2:UNIT 102
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2460
Mailing Address - Country:US
Mailing Address - Phone:502-240-6464
Mailing Address - Fax:502-222-0068
Practice Address - Street 1:10608 WATTERSON CENTER CT
Practice Address - Street 2:UNIT 102
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2460
Practice Address - Country:US
Practice Address - Phone:502-240-6464
Practice Address - Fax:502-222-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500005251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health