Provider Demographics
NPI:1629806609
Name:SHALOM HOME AND COMMUNITY CARE SERVICES, LLC
Entity type:Organization
Organization Name:SHALOM HOME AND COMMUNITY CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELEGANT
Authorized Official - Middle Name:
Authorized Official - Last Name:AFRIYIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-361-4002
Mailing Address - Street 1:3247 DESERETTE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3779
Mailing Address - Country:US
Mailing Address - Phone:424-361-4002
Mailing Address - Fax:
Practice Address - Street 1:3247 DESERETTE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3779
Practice Address - Country:US
Practice Address - Phone:424-361-4002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances