Provider Demographics
NPI:1932896776
Name:S-H OPCO VINTAGE PARK AL, LLC
Entity Type:Organization
Organization Name:S-H OPCO VINTAGE PARK AL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-918-5000
Mailing Address - Street 1:19929 CHASEWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1444
Mailing Address - Country:US
Mailing Address - Phone:281-320-9000
Mailing Address - Fax:
Practice Address - Street 1:19929 CHASEWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1444
Practice Address - Country:US
Practice Address - Phone:281-320-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility