Provider Demographics
NPI:1689027559
Name:SHANTI HOMECARE, LLC
Entity Type:Organization
Organization Name:SHANTI HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PIETTO
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:VASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-556-9566
Mailing Address - Street 1:482 SANTEE BLVD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-2518
Mailing Address - Country:US
Mailing Address - Phone:720-556-9566
Mailing Address - Fax:
Practice Address - Street 1:482 SANTEE BLVD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2518
Practice Address - Country:US
Practice Address - Phone:720-556-9566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)