Provider Demographics
NPI:1235615550
Name:SINAI MOUNTAIN HOMECARE
Entity Type:Organization
Organization Name:SINAI MOUNTAIN HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALDERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSH
Authorized Official - Phone:754-242-1900
Mailing Address - Street 1:464 CEDARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-6582
Mailing Address - Country:US
Mailing Address - Phone:915-321-4058
Mailing Address - Fax:915-321-4059
Practice Address - Street 1:464 CEDARWOOD AVE
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-6582
Practice Address - Country:US
Practice Address - Phone:915-321-4058
Practice Address - Fax:915-321-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Multi-Specialty