Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hospice Care, Community Based |
251G00000X | B4[14] | Hospice | |
Home Health |
251E00000X | A4[11] | Home Health Agency |
| NPI # | 1619769643 |
| LBN Legal business name | SHADY OAKS ASSISTED LIVING, LLC |
| Authorized official | TYSON BELANGER - (OWNER & DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/17/2025 |
| Last updated | 05/17/2025 - More than a year ago |
| Identifiers | n/a |
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