MEDICARE: HERO'S SHELTER INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency
3	251T00000X	PACE Provider Organization
4	251V00000X	Voluntary or Charitable Agency
5	253J00000X	Foster Care Agency
6	261QC1500X	Community Health Clinic/Center
7	261QC1800X	Corporate Health Clinic/Center
8	282J00000X	Religious Nonmedical Health Care Institution
9	332B00000X	Durable Medical Equipment & Medical Supplies
10	251K00000X	Public Health or Welfare Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
29	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962890053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERO'S SHELTER INC.

Provider Business Mailing Address
First Line	:	PO BOX 558
Second Line	:
City	:	SAN LUIS REY
State	:	CA
Zip	:	92068-0558
Country	:	US
Telephone Number	:	571-400-8461
Fax Number	:

Provider Business Practice Location Address
First Line	:	3646 OCEAN RANCH BLVD
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-2669
Country	:	US
Telephone Number	:	571-400-8461
Fax Number	:

Authorized Official
Title or Position	:	HEALTH SERVICES EXECUTIVE
Name	:	MS. OLUWAPELUMI OLUKOTUN
Credential	:	BSN, MSHA, APRN, CCM
Telephone Number	:	571-400-8461

Provider Enumeration Date	:	12/26/2014
Last Update Date	:	08/13/2020

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Directions to “HERO'S SHELTER INC. ” Practice Location

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