Shackleford Guiding Light LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SHACKLEFORD GUIDING LIGHT LLC

Practice address

687 Moore Rouse Rd
Snow Hill, NC 28580-7383

Phone

(252) 419-2407

NPI assigned

Jul 24, 2024

Last updated

Jul 24, 2024By 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

Sandra ShacklefordNPI 1831965292

Title

Owner

Phone

(252) 419-2407

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra Barrett Shackleford

  • Behavior Technician
  • Snow Hill, NC
  • NPI 1831965292
  NPD Authorized official

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1356179923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 MOORE ROUSE RD",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285807383",
            "telephone_number": "252-419-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 MOORE ROUSE RD",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285807383",
            "telephone_number": "252-419-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHACKLEFORD GUIDING LIGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "SHACKLEFORD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-419-2407"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Sanchez, LMFT, LMFTA
• Charlotte Bowman Sasser, RN
• George E. Schertzinger, OD
• George Logan Schertzinger, OD
• Sedcobb, LLC
• Sandra Barrett Shackleford
• Sincere Focused Care Managemnet, Inc.
• Snow Hill EMS, Inc.
• Snow Hill Healthcare, LLC (snow hill assisted living)
• Sozo Family Care Home Inc

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Snow Hill, NC
• Providers in Snow Hill, NC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.