1447400700 NPI number — SILVER THREADS, INC.

Table of content: (NPI 1447400700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447400700 NPI number — SILVER THREADS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SILVER THREADS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SILVER THREADS ASSISTED LIVING CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447400700
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 E 12TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREGORY
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57533-1181
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-832-9717
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 E 12TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREGORY
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57533-1181
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-832-9717
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUNVORDAHL
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
605-775-2531

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  APPLIED FOR , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)