NPIMap

Organization Active NPI

Shalom Heritage, LLC

  • Respite Care
  • Tempe, AZ
National Provider Identifier
1750093050
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
SHALOM HERITAGE, LLC
Practice address
6748 S Dennis Dr
Tempe, AZ 85283-5426
Phone
(480) 845-9165
NPI assigned
Dec 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
David Adebayo Oguntola
Title
Managing Director
Phone
(480) 845-9165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X Primary

Addresses

Primary practice location

6748 S Dennis Dr
Tempe, AZ 85283-5426

Mailing address

6748 S Dennis Dr
Tempe, AZ 85283-5426
Phone (480) 845-9165

Other identifiers 1

IdentifierTypeStateIssuer
156294MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Shalom Heritage LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1750093050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6748 S DENNIS DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852835426",
            "telephone_number": "480-845-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6748 S DENNIS DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852835426",
            "telephone_number": "480-845-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM HERITAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-18",
        "status": "A",
        "authorized_official_last_name": "OGUNTOLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ADEBAYO",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "480-845-9165"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156294",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.