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General NPI Number Information
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NPI Number | 1710562582
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Entity Type | Organization
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Legal Business Name | SHAEGA INC
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Dates
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Enumeration Date | 03/13/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 753 CARBONATE LN
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City | ERIE
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State | CO
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Zip | 80516-6580
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Country | US
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Telephone | 720-243-9639
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Fax |
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Provider Business Mailing Address
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Address Line | 191 JACKSON DR
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City | ERIE
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State | CO
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Zip | 80516-3644
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Country | US
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Telephone | 720-243-9639
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | NGAWANG LEKDEN
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Credential |
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Telephone | 720-243-9639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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