Provider Demographics
NPI:1154180222
Name:SILVER CREEK HOME CARE INC.
Entity type:Organization
Organization Name:SILVER CREEK HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-228-3331
Mailing Address - Street 1:6530 BOON LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-2614
Mailing Address - Country:US
Mailing Address - Phone:619-464-3479
Mailing Address - Fax:
Practice Address - Street 1:6530 BOON LAKE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-2614
Practice Address - Country:US
Practice Address - Phone:619-464-3479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home