Provider Demographics
NPI:1104113661
Name:SILVER RIDGE INC
Entity type:Organization
Organization Name:SILVER RIDGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDLACEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-332-4280
Mailing Address - Street 1:20332 HACKBERRY DR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-4951
Mailing Address - Country:US
Mailing Address - Phone:402-332-4280
Mailing Address - Fax:402-905-2319
Practice Address - Street 1:20332 HACKBERRY DR
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-4951
Practice Address - Country:US
Practice Address - Phone:402-332-4280
Practice Address - Fax:402-905-2319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility