Provider Demographics
NPI:1982961744
Name:SHAS, INC
Entity type:Organization
Organization Name:SHAS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ECENBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-483-6878
Mailing Address - Street 1:302 E JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802
Mailing Address - Country:US
Mailing Address - Phone:260-483-6878
Mailing Address - Fax:260-471-9234
Practice Address - Street 1:302 E JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-3114
Practice Address - Country:US
Practice Address - Phone:260-483-6878
Practice Address - Fax:260-471-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11-005869-01251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health