Provider Demographics
NPI:1033151972
Name:SHALOM HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:SHALOM HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:OKORIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-886-4881
Mailing Address - Street 1:12808 W AIRPORT BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6184
Mailing Address - Country:US
Mailing Address - Phone:832-886-4881
Mailing Address - Fax:832-886-4883
Practice Address - Street 1:12808 W AIRPORT BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6184
Practice Address - Country:US
Practice Address - Phone:832-886-4881
Practice Address - Fax:832-886-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX008865251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673155Medicare ID - Type UnspecifiedHOME HEALTH SERVICES
TX673155Medicare Oscar/Certification