1295075158 NPI number — SHILOH ADULT REHABILITATION & THERAPEUTIC DAY CENTER

Table of content: (NPI 1295075158)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295075158 NPI number — SHILOH ADULT REHABILITATION & THERAPEUTIC DAY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHILOH ADULT REHABILITATION & THERAPEUTIC DAY CENTER
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:
SHILOH ADULT DAY 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:
1295075158
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 807
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALIEF
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77411-0807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-933-1300
Provider Business Mailing Address Fax Number:
713-782-1359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8500 COOK RD
Provider Second Line Business Practice Location Address:
STE H
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77072-3944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-933-1300
Provider Business Practice Location Address Fax Number:
713-782-1359
Provider Enumeration Date:
02/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
AKINTUNDE
Authorized Official First Name:
FOLASADE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OFFICER
Authorized Official Telephone Number:
281-933-1300

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com