| Organization Name: | SHEPHERD SUPPORT SERVICES, LLC |
| NPI Number: | 1114049780 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HENRY DAVID HUNTER (GENERAL MANAGER) |
| Mailing Address: | 1010 Old Airport Rd Monett |
| State: | MO US |
| Postal Code: | 657089182 |
| Phone Number: | 4172360199 |
| Fax Number: | 4172360220 |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 690 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |