SHALOM BEHAVIORAL CARE LLC NPI 1619457785

NPI Information

NPI: 1619457785
Provider Name: SHALOM BEHAVIORAL CARE LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
35301 N BELGIAN BLUE CT
SAN TAN VALLEY, AZ
ZIP 85143
Phone: (480) 687-0462
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SHALOM BEHAVIORAL CARE LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in San Tan Valley, AZ. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. SHALOM BEHAVIORAL CARE LLC NPI is 1619457785. The provider is registered as an organization entity type.

The provider's business location address is:

35301 N BELGIAN BLUE CT
SAN TAN VALLEY, AZ
ZIP 85143
Phone: (480) 687-0462

The provider's authorized official is Anthony Vincent Olorunsola .
The authorized official title is Nurse Practitioner and has the following contact phone number (623) 806-6864.

The enumeration date for this NPI number is 8/18/2018 and was last updated on 8/28/2018.

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	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		BH5490	ARIZONA	Yes

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

NPI Synchronization or Removal

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