Provider Demographics
NPI:1184396061
Name:SILVER PINES CARE HOME I, LLC
Entity type:Organization
Organization Name:SILVER PINES CARE HOME I, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOESCH
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:916-308-2968
Mailing Address - Street 1:8625 HUME CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1731
Mailing Address - Country:US
Mailing Address - Phone:916-308-2968
Mailing Address - Fax:916-685-0608
Practice Address - Street 1:8625 HUME CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1731
Practice Address - Country:US
Practice Address - Phone:916-308-2968
Practice Address - Fax:916-685-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility