Healthcare Provider Details

I. General information

NPI: 1659085504
Provider Name (Legal Business Name): SLB HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2054 E BRIGADIER DR
GILBERT AZ
85298-9729
US

IV. Provider business mailing address

2054 E BRIGADIER DR
GILBERT AZ
85298-9729
US

V. Phone/Fax

Practice location:
  • Phone: 615-987-4377
  • Fax:
Mailing address:
  • Phone: 615-987-4377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHARI LEE BEAUREGARD
Title or Position: CEO/FOUNDER
Credential: NP
Phone: 615-987-4377