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General NPI Number Information
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NPI Number | 1396450615
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Entity Type | Organization
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Legal Business Name | SHAW HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 01/20/2023
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 500 GROSSMAN DR # 1007
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City | BRAINTREE
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State | MA
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Zip | 02184-4953
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Country | US
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Telephone | 857-615-6490
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Fax |
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Provider Business Mailing Address
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Address Line | 500 GROSSMAN DR # 1007
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City | BRAINTREE
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State | MA
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Zip | 02184-4953
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Country | US
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Telephone | 857-615-6490
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Fax |
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Authorized Official
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Title or Position | ONWER
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Name | MS. SHINEEKQUA ANITA WALKER
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Credential | C.N.A
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Telephone | 888-742-9427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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