MEDICARE: SHELTER RESOURCES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
4	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2203781817	OTHER	LA	STATE LICENSE NUMBER
2	2203781816	OTHER	LA	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1891265591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELTER RESOURCES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 3305
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70177-3305
Country	:	US
Telephone Number	:	504-945-9455
Fax Number	:	504-942-2660

Provider Business Practice Location Address
First Line	:	3029 ROYAL ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-6740
Country	:	US
Telephone Number	:	504-945-9455
Fax Number	:	504-942-2660

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. VICKI G. WEEKS
Credential	:
Telephone Number	:	504-942-2670

Provider Enumeration Date	:	11/26/2018
Last Update Date	:	12/12/2018

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Directions to “SHELTER RESOURCES, INC. ” Practice Location

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