Provider Demographics
NPI:1053858993
Name:SHANGRI-LA CORPORATION
Entity Type:Organization
Organization Name:SHANGRI-LA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-581-1732
Mailing Address - Street 1:398 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2310
Mailing Address - Country:US
Mailing Address - Phone:541-344-1121
Mailing Address - Fax:541-344-4210
Practice Address - Street 1:398 HIGH ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2310
Practice Address - Country:US
Practice Address - Phone:541-344-1121
Practice Address - Fax:541-344-4210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health