Provider Demographics
NPI:1336767110
Name:SH OPCO ABILENE LLC
Entity type:Organization
Organization Name:SH OPCO ABILENE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-308-8391
Mailing Address - Street 1:14160 DALLAS PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-4383
Mailing Address - Country:US
Mailing Address - Phone:972-308-8391
Mailing Address - Fax:972-340-2691
Practice Address - Street 1:3234 BUFFALO GAP RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-7009
Practice Address - Country:US
Practice Address - Phone:325-793-1144
Practice Address - Fax:325-793-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147481OtherTEXAS HELATH AND HUMAN SERVICES