SH Opco Abilene LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SH OPCO ABILENE LLC

Doing business as

Covenant Place of Abilene

Practice address

3234 Buffalo Gap Rd
Abilene, TX 79605-7009

Phone

(325) 793-1144

Fax

(325) 793-1422

NPI assigned

Jul 8, 2020

Organization subpart

No

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

Authorized official

Name

Darla Brown

Title

Ar Manager

Phone

(972) 308-8391

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Covenant Place of Abilene Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1336767110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14160 DALLAS PKWY STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752544383",
            "telephone_number": "972-308-8391",
            "fax_number": "972-340-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3234 BUFFALO GAP RD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796057009",
            "telephone_number": "325-793-1144",
            "fax_number": "325-793-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH OPCO ABILENE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "972-308-8391"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS HELATH AND HUMAN SERVICES",
            "identifier": "147481",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "none",
            "affiliation": "N",
            "address_1": "3234 Buffalo Gap Rd",
            "city": "Abilene",
            "state": "TX",
            "country_code": "US",
            "postal_code": "796057009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Covenant Place of Abilene",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenna Seiler
• Anastasia Self, LMT
• Misty Mari Sepeda
• Serenity Foundation of Texas
• Daniela Serrano
• Shelda Mae Shaffer, O.D.
• Tushar M Shah, M.D.
• Michael Todd Shanks, O.D.
• Caleb Shannon, APRN, FNP-C
• Joe M Sharp, DDS

• Assisted Living Facility in Abilene, TX
• Providers in Abilene, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.