Provider Demographics
NPI:1669593919
Name:SILVERAGE HOME HEALTH CARE SERVICE INC
Entity type:Organization
Organization Name:SILVERAGE HOME HEALTH CARE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADETUTU
Authorized Official - Middle Name:K
Authorized Official - Last Name:ETTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-569-2821
Mailing Address - Street 1:4018 WILTSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-7630
Mailing Address - Country:US
Mailing Address - Phone:469-569-2821
Mailing Address - Fax:972-240-9597
Practice Address - Street 1:4018 WILTSHIRE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-7630
Practice Address - Country:US
Practice Address - Phone:469-569-2821
Practice Address - Fax:972-240-9597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health