Shadow Mountain Luxury Senior Living Corporation

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SHADOW MOUNTAIN LUXURY SENIOR LIVING CORPORATION

Practice address

13000 Cowper Dr
Frisco, TX 75035-2220

Phone

(214) 399-9099

NPI assigned

Feb 6, 2019

Last updated

Feb 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Juliet Otieno

Title

Owner

Phone

(214) 399-9099

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1245795970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 COWPER DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750352220",
            "telephone_number": "214-399-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 COWPER DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750352220",
            "telephone_number": "214-399-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN LUXURY SENIOR LIVING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "OTIENO",
        "authorized_official_first_name": "JULIET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-399-9099"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ama Nyarko Sey, LVN
• Katherine Seyb, CCCC, MS/SLP
• Laura Seyffert
• Michelle Seyl, LPC-A
• Shaalon Joules PHD PLLC
• Kelley Shaffer, PA-C
• Minnah Shafi
• Shanila Shagufta, MD
• Aditi Dhaval Shah, PT
• Bina S Shah, FNP

• Adult Care Home Facility in Frisco, TX
• Providers in Frisco, TX by specialty
• Adult Care Home Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.