Shalimar Gardens Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALF257 Issued in NE

Legal business name

SHALIMAR GARDENS ASSISTED LIVING

Practice address

749 E 29TH St
Fremont, NE 68025-7711

Phone

(402) 721-1616

Fax

(402) 753-8080

NPI assigned

May 24, 2011

Organization subpart

No

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

Authorized official

Name

Ina Carroll, RN

Title

Executive Director

Phone

(402) 721-1616

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1508159591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "749 E 29TH ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257711",
            "telephone_number": "402-721-1616",
            "fax_number": "402-753-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 E 29TH ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257711",
            "telephone_number": "402-721-1616",
            "fax_number": "402-753-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALIMAR GARDENS ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "INA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-721-1616",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NE",
            "license": "ALF257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100252898-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Seeman
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• Judy Sharrai
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• Shannon Sheets
• Shiloh Center Adult Day Services

• Assisted Living Facility in Fremont, NE
• Providers in Fremont, NE by specialty
• Assisted Living Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.