Healthcare Provider Details

I. General information

NPI: 1538005251
Provider Name (Legal Business Name): SHANI ASSISTANT LIVING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S LOUDON AVE UNIT 25364
BALTIMORE MD
21229-7532
US

IV. Provider business mailing address

340 S LOUDON AVE
BALTIMORE MD
21229-7500
US

V. Phone/Fax

Practice location:
  • Phone: 443-851-3699
  • Fax:
Mailing address:
  • Phone: 443-851-3699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: CHINTAN PATEL
Title or Position: MANAGER
Credential:
Phone: 443-851-3699