Provider Demographics
NPI:1043723430
Name:SHALOM THERAPY SERVICES LLC
Entity type:Organization
Organization Name:SHALOM THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-692-4839
Mailing Address - Street 1:26206 W 12 MILE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-8500
Mailing Address - Country:US
Mailing Address - Phone:248-756-7229
Mailing Address - Fax:248-864-8251
Practice Address - Street 1:26206 W 12 MILE RD STE 204
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-8500
Practice Address - Country:US
Practice Address - Phone:248-756-7229
Practice Address - Fax:248-756-7229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy