Provider Demographics
NPI:1548027725
Name:SHALOM HOME LIVING LLC
Entity type:Organization
Organization Name:SHALOM HOME LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRUHURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-525-7801
Mailing Address - Street 1:4471 91ST ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-7413
Mailing Address - Country:US
Mailing Address - Phone:151-552-5801
Mailing Address - Fax:
Practice Address - Street 1:4471 91ST ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7413
Practice Address - Country:US
Practice Address - Phone:151-552-5801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EUGENE KIRUHURA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No253Z00000XAgenciesIn Home Supportive Care