Provider Demographics
NPI:1245568781
Name:SHIRLEY HOME FOR THE AGED, INC.
Entity Type:Organization
Organization Name:SHIRLEY HOME FOR THE AGED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-447-3781
Mailing Address - Street 1:17050 COUNTRY VIEW LANE
Mailing Address - Street 2:
Mailing Address - City:SHIRLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17260-9534
Mailing Address - Country:US
Mailing Address - Phone:814-447-3781
Mailing Address - Fax:814-447-5601
Practice Address - Street 1:17050 COUNTRY VIEW LANE
Practice Address - Street 2:
Practice Address - City:SHIRLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17260-9534
Practice Address - Country:US
Practice Address - Phone:814-447-3781
Practice Address - Fax:814-447-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty