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General NPI Number Information
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NPI Number | 1811226368
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Entity Type | Organization
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Legal Business Name | SHIRLEY MEADOWS
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 247 KYLE MAC WAY RD
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City | RUFFIN
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State | NC
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Zip | 27326-9602
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Country | US
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Telephone | 336-939-9934
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Fax |
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Provider Business Mailing Address
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Address Line | 247 KYLE MAC WAY RD
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City | RUFFIN
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State | NC
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Zip | 27326-9602
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Country | US
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Telephone | 336-939-9934
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. SHANNON SIMPSON
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Credential |
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Telephone | 336-939-9934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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