Provider Demographics
NPI:1629501358
Name:SHANAH CARE SERVICES
Entity Type:Organization
Organization Name:SHANAH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAIBU NOMBRE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABDUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-473-0530
Mailing Address - Street 1:6012 S TELLURIDE CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3200
Mailing Address - Country:US
Mailing Address - Phone:720-473-0530
Mailing Address - Fax:
Practice Address - Street 1:6012 S. TELLURIDE CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016
Practice Address - Country:US
Practice Address - Phone:720-473-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health