Shana's Place Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SHANA'S PLACE ASSISTED LIVING

Doing business as

Shana's Place Assisted Living

Practice address

204 Vale St
Palmer Lake, CO 80133-9400

Phone

(719) 310-8836

Fax

(719) 982-7559

NPI assigned

Jan 11, 2024

Last updated

Jan 11, 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

Shana BallNPI 1568086213

Title

Owner/Administrator

Phone

(719) 310-8836

Specialties & licenses 1

Addresses

Other names 1

• Shana's Place Assisted Living Doing business as

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.

• Shana Ball, CNA

  • Nurse's Aide
  • Palmer Lake, CO
  • NPI 1568086213
  NPD Authorized official

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1538930227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 VALE ST",
            "city": "PALMER LAKE",
            "state": "CO",
            "postal_code": "801339400",
            "telephone_number": "719-310-8836",
            "fax_number": "719-982-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 VALE ST",
            "city": "PALMER LAKE",
            "state": "CO",
            "postal_code": "801339400",
            "telephone_number": "719-310-8836",
            "fax_number": "719-982-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANA'S PLACE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "719-310-8836"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shana's Place Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tania Lorell Rife, M.A., CCC/SLP
• Michelle Roberts, LSW
• David Robinson, CAS 6388
• Anthony Rodenbaugh
• Dawn Sakamoto
• Sarah Shepherd, RD
• Heather Lee Simpson, CMT
• Sayeh S. Sparr
• Caroline Honora Stork, LSW, CCTP, CADC
• Sueellen Vest, LPC

• Assisted Living Facility in Palmer Lake, CO
• Providers in Palmer Lake, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.