Provider Demographics
NPI:1174671655
Name:SHALOM HOME CARE, INC.
Entity Type:Organization
Organization Name:SHALOM HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSEELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PERAKATHU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-504-9321
Mailing Address - Street 1:2701 E PRICE RD STE F
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2472
Mailing Address - Country:US
Mailing Address - Phone:956-504-9321
Mailing Address - Fax:956-504-9377
Practice Address - Street 1:2701 E PRICE RD STE F
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2472
Practice Address - Country:US
Practice Address - Phone:956-504-9321
Practice Address - Fax:956-504-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX006957251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health