NPI 1619457785
Shalom Behavioral Care LLC
Practice location
- Address
- 35301 N Belgian Blue CT, San Tan Valley, AZ 85143
- Phone
- (480) 687-0462
- Mailing address
- 35301 N Belgian Blue CT, San Tan Valley, AZ 85143-5497
Authorised official
- Name
- Anthony Vincent Olorunsola
- Title
- Nurse Practitioner
- Phone
- (623) 806-6864
Registered specialties
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1619457785
- Entity type
- Organization
- NPI issued
- 18 Aug 2018
- Record last updated
- 28 Aug 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.