Shelby House LLC

Key facts

NPI

1124456355

Entity type

Organization (NPI type 2)

Primary specialty

Adult Care Home Facility 311ZA0620X

Legal business name

SHELBY HOUSE LLC

Practice address

950 Hardin Dr
Shelby, NC 28150-3500

Phone

(828) 261-7304

Fax

(828) 326-8109

NPI assigned

Oct 25, 2013

Organization subpart

No

Authorized official

Name

Mr. Charles E Trefzger Jr.

Title

Manager

Phone

(828) 322-5535

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

National Provider Directory

Specialties & licenses

Addresses

Other names

• Cleveland House Doing business as
• Shelby House Former legal business name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 18, 2021.

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1124456355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2568",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286032568",
            "telephone_number": "828-261-7304",
            "fax_number": "828-326-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 HARDIN DR",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503500",
            "telephone_number": "828-261-7304",
            "fax_number": "828-326-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-25",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-322-5535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL023045",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland House",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shelby House",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Shelby House",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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All providers in Shelby, NC · Adult Care Home Facility in North Carolina