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General NPI Number Information
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NPI Number | 1144834318
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Entity Type | Organization
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Legal Business Name | HOUSE OF SHELTER INCORPORATED
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 15757 W MORELAND ST
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City | GOODYEAR
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State | AZ
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Zip | 85338-4161
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Country | US
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Telephone | 623-221-1579
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Fax |
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Provider Business Mailing Address
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Address Line | 15757 W MORELAND ST
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City | GOODYEAR
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State | AZ
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Zip | 85338-4161
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Country | US
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Telephone | 623-221-1579
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Fax |
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Authorized Official
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Title or Position | CEO/PROVIDER
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Name | FLOYD H JONES
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Credential | MPA
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Telephone | 623-221-1579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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