NPIMap

Organization Active NPI

Shore Up Inc

Doing business as Shady Pines Adult Day Services

  • Adult Day Care Clinic/Center
  • Salisbury, MD
National Provider Identifier
1225221658
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
22001 Issued in MD
Legal business name
SHORE UP INC
Doing business as
Shady Pines Adult Day Services
Practice address
1929 Northwood Dr
Salisbury, MD 21801-7828
Phone
(443) 523-0050
Fax
(443) 523-0053
NPI assigned
Aug 20, 2007
Organization subpart
Yes
Parent organization
SHORE UP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Freddy L. Mitchell
Title
Executive Director
Phone
(410) 749-1142

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 22001 MD Primary

Addresses

Primary practice location

1929 Northwood Dr
Salisbury, MD 21801-7828

Mailing address

520 Snow Hill Rd
Salisbury, MD 21804-6031
Phone (410) 749-1142

Other names 1

  • Shady Pines Adult Day Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shore Up Inc3 organizations share this tax ID, including this one
Part of
Shore Up Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1929 Northwood Dr
Salisbury, MD 21801
Phone (443) 523-0050

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1225221658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SNOW HILL RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046031",
            "telephone_number": "410-749-1142",
            "fax_number": "410-742-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 NORTHWOOD DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017828",
            "telephone_number": "443-523-0050",
            "fax_number": "443-523-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE UP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHORE UP INC",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "FREDDY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-749-1142",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MD",
            "license": "22001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shady Pines Adult Day Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.