Healthcare Provider Details
I. General information
NPI: 1598868721
Provider Name (Legal Business Name): SHALEM INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/06/2006
Last Update Date: 08/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
881 HIGH ST SUITE 206
WORTHINGTON OH
43085-4109
US
IV. Provider business mailing address
881 HIGH ST SUITE 206
WORTHINGTON OH
43085-4109
US
V. Phone/Fax
- Phone: 614-441-9773
- Fax: 209-755-5766
- Phone: 614-441-9773
- Fax: 209-755-5766
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | N/A |
| License Number State | OH |
VIII. Authorized Official
Name: DR.
ELIZABETH
ANNE
REED
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 614-441-9773