Provider Demographics
NPI:1649375122
Name:SHEPHERD'S SERVICES, INC.
Entity type:Organization
Organization Name:SHEPHERD'S SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-803-3000
Mailing Address - Street 1:125 HERITAGE ROW
Mailing Address - Street 2:
Mailing Address - City:MARLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76661-2841
Mailing Address - Country:US
Mailing Address - Phone:254-803-3000
Mailing Address - Fax:254-883-3530
Practice Address - Street 1:125 HERITAGE ROW
Practice Address - Street 2:
Practice Address - City:MARLIN
Practice Address - State:TX
Practice Address - Zip Code:76661-2841
Practice Address - Country:US
Practice Address - Phone:254-803-3000
Practice Address - Fax:254-883-3530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016582251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677796Medicare UPIN