SILVER SPARKS RESIDENTIAL CARE LLC DBA ADULT LEISURE LIVING NPI 1497453088

NPI Information

NPI: 1497453088
Provider Name: SILVER SPARKS RESIDENTIAL CARE LLC DBA ADULT LEISURE LIVING
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
15650 W BUNCHE PARK DR
MIAMI GARDENS, FL
ZIP 33054
Phone: (305) 705-2347
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SILVER SPARKS RESIDENTIAL CARE LLC DBA ADULT LEISURE LIVING is an assisted living facility in Miami Gardens, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SILVER SPARKS RESIDENTIAL CARE LLC DBA ADULT LEISURE LIVING NPI is 1497453088. The provider is registered as an organization entity type.

The provider's business location address is:

15650 W BUNCHE PARK DR
MIAMI GARDENS, FL
ZIP 33054-965
Phone: (305) 705-2347

The provider's authorized official is Lavern Marie Gordon Thomas .
The authorized official title is Administrator and has the following contact phone number (786) 506-6778.

The enumeration date for this NPI number is 2/22/2023 and was last updated on 2/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12063	OTHER	FLORIDA	AGENCY FOR HEALTHCARE ADMINISTRATION LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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