Provider Demographics
NPI:1457144958
Name:SHANGRI-LA LLC
Entity type:Organization
Organization Name:SHANGRI-LA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SANJAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-682-8594
Mailing Address - Street 1:277 UNIVERSITY CIR
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-3601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:277 UNIVERSITY CIR
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-3601
Practice Address - Country:US
Practice Address - Phone:603-682-8594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities