Provider Demographics
NPI:1558525816
Name:SHAHN PLACE, INC.
Entity Type:Organization
Organization Name:SHAHN PLACE, INC.
Other - Org Name:SHAUN'S PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAT
Authorized Official - Middle Name:ODHAMS
Authorized Official - Last Name:WESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-376-7050
Mailing Address - Street 1:2200 E LEDBETTER DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7408
Mailing Address - Country:US
Mailing Address - Phone:214-376-7050
Mailing Address - Fax:214-372-1434
Practice Address - Street 1:2200 E LEDBETTER DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7408
Practice Address - Country:US
Practice Address - Phone:214-376-7050
Practice Address - Fax:214-372-1434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302879251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management