Provider Demographics
NPI:1487193462
Name:SHALOM CITY HEALTH CARE
Entity Type:Organization
Organization Name:SHALOM CITY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHINENYE
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:AMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-463-7794
Mailing Address - Street 1:19378 STRATHMORE PLACE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3669
Mailing Address - Country:US
Mailing Address - Phone:281-463-7794
Mailing Address - Fax:
Practice Address - Street 1:19378 STRATHMORE PLACE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-3669
Practice Address - Country:US
Practice Address - Phone:281-463-7794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health