Provider Demographics
NPI:1164627147
Name:SHAYLEE CARES, INC.
Entity Type:Organization
Organization Name:SHAYLEE CARES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LA VERNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-398-4296
Mailing Address - Street 1:PO BOX 741879
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-1879
Mailing Address - Country:US
Mailing Address - Phone:504-398-4296
Mailing Address - Fax:504-398-4297
Practice Address - Street 1:1601 BELLE CHASSE HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-7011
Practice Address - Country:US
Practice Address - Phone:504-398-4296
Practice Address - Fax:504-398-4297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1197611Medicaid