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General NPI Number Information
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NPI Number | 1396965745
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Entity Type | Organization
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Legal Business Name | SHENANDOAH INC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 SCHOOL ST.
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City | WEST POINT
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State | AR
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Zip | 72178
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Country | US
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Telephone | 501-742-3563
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Fax | 501-742-3868
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Provider Business Mailing Address
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Address Line | 106 SCHOOL ST. P.O. BOX 35
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City | WEST POINT
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State | AR
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Zip | 72178-0035
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Country | US
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Telephone | 501-742-3563
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Fax | 501-742-3868
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Authorized Official
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Title or Position | PRESIDENT - OWNER
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Name | MR. JAMES MASON CARTER
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Credential |
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Telephone | 501-742-3563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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