Shirley M Anderson

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

118552 Issued in TX

Legal business name

SHIRLEY M ANDERSON

Doing business as

New Life Outreach Boarding Homes

Practice address

1511 S Mobberly Ave
Longview, TX 75602-2935

Phone

(903) 758-9353

Fax

(903) 758-9153

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Frances Meader

Title

Administrator

Phone

(903) 387-3432

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• NEW LIFE OUTREACH BOARDING HOMES Doing business as

Tax ID family

New Life Outreach Boarding Homes2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Shirley M Anderson

  dba New Life Outreach Boarding Homes

  • Assisted Living Facility (Mental Illness)
  • Longview, TX
  • NPI 1679793319
  NPD tax ID

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1346468444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12478",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756072478",
            "telephone_number": "903-758-9353",
            "fax_number": "903-758-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 S MOBBERLY AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756022935",
            "telephone_number": "903-758-9353",
            "fax_number": "903-758-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIRLEY M ANDERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "MEADER",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-387-3432"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "TX",
            "license": "118552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001003304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW LIFE OUTREACH BOARDING HOMES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carroll L Sherman, DDS, MS
• Darrel Sherman
• Fangting Shi
• Anne E. Shields, FNP, CS P-MH
• Jennifer Lynn Shipp, FNP-BC
• Shirley M Anderson (New Life Outreach Boarding Homes)
• Billy Dale Shirley, RPH
• Sheena Shirley
• Shorr Hospice Holdings LLC (Prime Care Hospice II)
• Colleen Acadia Short, LMFT, LMHC

• Assisted Living Facility (Mental Illness) in Longview, TX
• Providers in Longview, TX by specialty
• Assisted Living Facility (Mental Illness) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.