NPI 1013375310

Lan Silver Pines LLC

Organisation Custodial Care Facility Cedar Rapids, IA

Practice location

Address: 136 36th Ave SW, Cedar Rapids, IA 52404-4638
Phone: (319) 362-6868
Fax: (319) 363-7312
Mailing address: 4252 Manor Dr, Marshall, VA 20115-3701

Authorised official

Name: Shanda London
Title: Authorized Official
Phone: (206) 623-6239

Registered specialties

Custodial Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311Z00000X

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Registry record

NPI: 1013375310
Entity type: Organization
NPI issued: 2 Feb 2016
Record last updated: 2 Feb 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.