Healthcare Provider Details

I. General information

NPI: 1932829330
Provider Name (Legal Business Name): SHILOH HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 E EASTER LN
CENTENNIAL CO
80112-1136
US

IV. Provider business mailing address

6400 W COAL MINE AVE
LITTLETON CO
80123-4501
US

V. Phone/Fax

Practice location:
  • Phone: 303-933-1393
  • Fax:
Mailing address:
  • Phone: 303-933-1393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: STEVEN RAMIREZ
Title or Position: CEO
Credential:
Phone: 303-933-1393