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SHALOM HOME CARE CORPORATION LLC DBA SHALOM HOME CARE NPI 1114384476


NPI Information

NPI: 1114384476
Provider Name: SHALOM HOME CARE CORPORATION LLC DBA SHALOM HOME CARE
Classification: In Home Supportive Care - 253Z00000X
Entity Type: Organization

CLIA Number: 06D2233082

Address:
134 LAMAR AVE
PUEBLO, CO
ZIP 81004
Phone: (719) 542-2715
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SHALOM HOME CARE CORPORATION LLC DBA SHALOM HOME CARE is an in home supportive care in Pueblo, CO. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. SHALOM HOME CARE CORPORATION LLC DBA SHALOM HOME CARE NPI is 1114384476. The provider is registered as an organization entity type.

The provider's business location address is:

134 LAMAR AVE
PUEBLO, CO
ZIP 81004-907
Phone: (719) 542-2715
Fax: (719) 543-6358

The provider's authorized official is Gilbert J Pacheco .
The authorized official title is Owner/operator and has the following contact phone number (719) 542-2715.

The CLIA number assigned to this NPI record is 06D2233082 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2016 and was last updated on 1/18/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1253Z00000XIn Home Supportive Care230659COLORADOYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
132771754MEDICAIDCOLORADO

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: 4/28/2024

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