Provider Demographics
NPI:1003221300
Name:S-H OPCO CARLSBAD, LLC
Entity Type:Organization
Organization Name:S-H OPCO CARLSBAD, LLC
Other - Org Name:BAYSHIRE CARLSBAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRAGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-728-9063
Mailing Address - Street 1:3140 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3140 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2108
Practice Address - Country:US
Practice Address - Phone:760-720-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
555745Medicare Oscar/Certification