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General NPI Number Information
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NPI Number | 1962779819
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Entity Type | Organization
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Legal Business Name | ALLSHOUSE SUPPORTED LIVING SERVICES
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 7738 70TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3001
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Country | US
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Telephone | 727-538-7772
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Fax | 727-538-4244
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Provider Business Mailing Address
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Address Line | 7738 70TH ST N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3001
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Country | US
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Telephone | 727-538-7772
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Fax | 727-538-4244
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Authorized Official
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Title or Position | OWNER/OPPERATOR
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Name | MR. SHAWN ALLSHOUSE
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Credential |
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Telephone | 727-538-7772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 001801400
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License Number State | FL
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