Provider Demographics
NPI:1114757788
Name:SHEKINAH CARE LLC
Entity type:Organization
Organization Name:SHEKINAH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAGALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-509-6865
Mailing Address - Street 1:15524 SALMON SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-2208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15524 SALMON SPRINGS DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302-2208
Practice Address - Country:US
Practice Address - Phone:346-509-6865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities