Provider Demographics
NPI:1275756512
Name:SHILOH HOME INC.
Entity Type:Organization
Organization Name:SHILOH HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUITVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-932-9599
Mailing Address - Street 1:6400 W COAL MINE AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-4501
Mailing Address - Country:US
Mailing Address - Phone:303-932-9599
Mailing Address - Fax:
Practice Address - Street 1:7623 S ESTES CT
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-5223
Practice Address - Country:US
Practice Address - Phone:303-932-9599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20335322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84933372Medicaid