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SHORE UP INC NPI 1225221658


NPI Information

NPI: 1225221658
Provider Name: SHORE UP INC

Doing Business As: SHADY PINES ADULT DAY SERVICES

Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

CLIA Number: 21D0896708

Address:
1929 NORTHWOOD DR
SALISBURY, MD
ZIP 21801
Phone: (443) 523-0050
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SHORE UP INC is an adult day care clinic center in Salisbury, MD. SHORE UP INC NPI is 1225221658. The provider is registered as an organization entity type.
The provider Is Doing Business As Shady Pines Adult Day Services.

The provider's business location address is:

1929 NORTHWOOD DR
SALISBURY, MD
ZIP 21801-828
Phone: (443) 523-0050
Fax: (443) 523-0053

The provider's authorized official is Freddy L. Mitchell .
The authorized official title is Executive Director and has the following contact phone number (410) 749-1142.

The CLIA number assigned to this NPI record is 21D0896708 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/20/2007 and was last updated on 8/20/2007.


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
1261QA0600XClinic/CenterAdult Day Care22001MARYLANDYes

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

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