{
"Npi": {
"NPI": "1083324404",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHALOM HEALTH CARE MANAGEMENT LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1500 S DAIRY ASHFORD RD STE 200",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOUSTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77077-3858",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-402-0169",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "950 WASHINGTON BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEAUMONT",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77705-2251",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-402-0169",
"PracticeLocationAddressFaxNumber": "409-600-2869",
"EnumerationDate": "11/28/2022",
"LastUpdateDate": "05/16/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NABIL",
"AuthorizedOfficialFirstName": "ABRAHAM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "713-705-3490",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QR0405X",
"TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "324500000X",
"TaxonomyName": "Substance Abuse Rehabilitation Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}