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Contact Information

SHADY SHORES OF SAN SABA LLC
2400 WEST BROWN ST.
SAN SABA, TX76877
 Phone: 325-455-3200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for SHADY SHORES OF SAN SABA LLC

NPI Number 1326408832
LBN Legal business name SHADY SHORES OF SAN SABA LLC
Authorized official MICHAEL WALLACE - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/25/2016
Last updated 11/14/2016 - About 10 years ago
Identifiers
TX Medicaid 001027949
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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