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SHELBY OPCO LLC NPI 1689171431


NPI Information

NPI: 1689171431
Provider Name: SHELBY OPCO, LLC

Doing Business As: SHELBY MANOR

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 34D2152242

Address:
1176 WYKE RD
SHELBY, NC
ZIP 28150
Phone: (704) 482-0000
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SHELBY OPCO, LLC is an adult care home custodial care facility in Shelby, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. SHELBY OPCO, LLC NPI is 1689171431. The provider is registered as an organization entity type.
The provider Is Doing Business As Shelby Manor.

The provider's business location address is:

1176 WYKE RD
SHELBY, NC
ZIP 28150-273
Phone: (704) 482-0000

The provider's authorized official is Charles E Trefzger .
The authorized official title is Manager and has the following contact phone number (828) 322-5535.

The CLIA number assigned to this NPI record is 34D2152242 - other - pre-screening for trials with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/9/2018 and was last updated on 11/9/2021.


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
1310400000XAssisted Living FacilityHAL023046NORTH CAROLINANo
2343900000XNon-emergency Medical Transport (VAN)No
3311ZA0620XCustodial Care FacilityAdult Care HomeYes

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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