Provider Demographics
NPI:1669139226
Name:SILVER AGE ADULT DAY CARE LLC
Entity type:Organization
Organization Name:SILVER AGE ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-708-3905
Mailing Address - Street 1:10880 BISSONNET ST STE 140D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-2166
Mailing Address - Country:US
Mailing Address - Phone:832-708-3905
Mailing Address - Fax:
Practice Address - Street 1:10880 BISSONNET ST STE 140D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-2166
Practice Address - Country:US
Practice Address - Phone:832-708-3905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care