Shalom Treatment Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SHALOM TREATMENT CENTER LLC

Practice address

3844 N 24TH St
Phoenix, AZ 85016-6513

Phone

(240) 559-7617

NPI assigned

Oct 2, 2023

Organization subpart

No

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

Authorized official

Name

Scovia Basaliza

Title

Chief Executive Officer

Phone

(240) 559-7617

Specialties & licenses 1

Addresses

Other names 1

• Shalom Treatment Center LLC Doing business as

Locations

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1477333995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3844 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166513",
            "telephone_number": "240-559-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3844 N 24TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166513",
            "telephone_number": "240-559-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "BASALIZA",
        "authorized_official_first_name": "SCOVIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "240-559-7617"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shalom Treatment Center LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hazael Shakur
• Esther Shalamov, FNP
• Jacob Charles Shalkevich, MD
• Shalom DME Supplier Inc.
• Shalom Home Care LLC
• Sham M Vengurlekar, MD, PC
• Rachel Weinstein Shamah, MS OTRL
• Younus Mohammed Khaleel Shamam
• Quentin C Shambley
• Ayesha Shamim

• Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.