Provider Demographics
NPI:1275388092
Name:SHIELDS FOUNDATION LLC
Entity Type:Organization
Organization Name:SHIELDS FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-353-9132
Mailing Address - Street 1:2253 S ONEIDA ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2562
Mailing Address - Country:US
Mailing Address - Phone:720-746-9254
Mailing Address - Fax:
Practice Address - Street 1:4660 S EASTERN AVE STE 108A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6137
Practice Address - Country:US
Practice Address - Phone:720-746-9254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities