Provider Demographics
NPI:1891097747
Name:SHAN GROUP LLC
Entity Type:Organization
Organization Name:SHAN GROUP LLC
Other - Org Name:ACCESSIBLE HOME HEALTH CARE OF AVENTURA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDSAURWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-627-3103
Mailing Address - Street 1:15251 NE 18TH AVE
Mailing Address - Street 2:SUITE 9 AND 11
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-6039
Mailing Address - Country:US
Mailing Address - Phone:305-627-3103
Mailing Address - Fax:305-627-3421
Practice Address - Street 1:15251 NE 18TH AVE
Practice Address - Street 2:SUITE 9 AND 11
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-6039
Practice Address - Country:US
Practice Address - Phone:305-627-3103
Practice Address - Fax:305-627-3421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health