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General NPI Number Information
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NPI Number | 1245568781
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Entity Type | Organization
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Legal Business Name | SHIRLEY HOME FOR THE AGED, INC.
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 17050 COUNTRY VIEW LANE
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City | SHIRLEYSBURG
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State | PA
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Zip | 17260-9534
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Country | US
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Telephone | 814-447-3781
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Fax | 814-447-5601
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Provider Business Mailing Address
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Address Line | 17050 COUNTRY VIEW LANE
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City | SHIRLEYSBURG
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State | PA
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Zip | 17260-9534
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Country | US
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Telephone | 814-447-3781
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Fax | 814-447-5601
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BOBBI JO LANDRUM
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Credential |
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Telephone | 814-447-3781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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