| Organization Name: | SHALOM HOUSE INC #2 |
| NPI Number: | 1669863486 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NORMA L POINDEXTER (OWNER) |
| Mailing Address: | 13905 E 39th St S Ste 104 Independence |
| State: | MO US |
| Postal Code: | 640553378 |
| Phone Number: | 8162728181 |
| Fax Number: | 8162564182 |
| NPI Enumeration Date: | 02/16/2015 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |