Provider Demographics
NPI:1265685648
Name:SHELTERED LIVING, INC.
Entity Type:Organization
Organization Name:SHELTERED LIVING, INC.
Other - Org Name:SHELTERED LIVING, INC. HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-233-2566
Mailing Address - Street 1:3401 SW HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2277
Mailing Address - Country:US
Mailing Address - Phone:785-233-2566
Mailing Address - Fax:785-266-8709
Practice Address - Street 1:3401 SW HARRISON ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2277
Practice Address - Country:US
Practice Address - Phone:785-233-2566
Practice Address - Fax:785-266-8709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty