NPI 1902299985
Shangri-La, LLC
Practice location
- Address
- 3650 Butor Rd, North Prince George, VA 23860-7429
- Phone
- (804) 541-3589
- Mailing address
- PO Box 1014, Prince George, VA 23875-0961
Authorised official
- Name
- Loretta Faulknier
- Title
- Chief Executive Officer
- Phone
- (804) 541-3589
Registered specialties
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1902299985
- Entity type
- Organization
- NPI issued
- 14 Mar 2015
- Record last updated
- 14 Mar 2015
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.