Provider Demographics
NPI:1760202998
Name:SILVER LANTERN HOMECARE LLC
Entity type:Organization
Organization Name:SILVER LANTERN HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-205-1010
Mailing Address - Street 1:30115 VERDANT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1627
Mailing Address - Country:US
Mailing Address - Phone:832-368-1289
Mailing Address - Fax:
Practice Address - Street 1:30115 VERDANT CREEK DR
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1627
Practice Address - Country:US
Practice Address - Phone:832-368-1289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care