Healthcare Provider Details

I. General information

NPI: 1437020294
Provider Name (Legal Business Name): SHORA HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6639 CENTURION DR STE 120
LANSING MI
48917-8273
US

IV. Provider business mailing address

6639 CENTURION DR STE 120
LANSING MI
48917-8273
US

V. Phone/Fax

Practice location:
  • Phone: 517-258-0364
  • Fax: 517-299-1027
Mailing address:
  • Phone: 517-258-0364
  • Fax: 517-299-1027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAUREN FREY
Title or Position: OWNER
Credential: LMSW-C
Phone: 517-295-3309