Shiloh Treatment Center, Inc.

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

TDFPS517689 Issued in TX

Legal business name

SHILOH TREATMENT CENTER, INC.

Practice address

4774 Del Bello Rd
Manvel, TX 77578

Phone

(281) 489-1290

Fax

(281) 489-0167

NPI assigned

Nov 14, 2006

Last updated

Nov 1, 2023By 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

Dr. Luis A Valdes, PHDNPI 1023128998

Title

Administrator

Phone

(281) 489-1290

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

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.

• Lance Carroll, M.D.

  • Family Medicine Physician
  • Bastrop, TX
  • NPI 1619050952
  Medicare reassignment
• Luis Antero Valdes, PHD

  • Psychologist
  • Pearland, TX
  • NPI 1023128998
  Authorized official Same address or phone
• Dominick S D'Aunno, MD

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1881652436
  NPD (past)
• Rafael D Guerrero, M.D.

  • Psychiatry Physician
  • Katy, TX
  • NPI 1386600138
  NPD (past)
• Nina Grena Herring, FNP-C, PMHNP-B

  • Family Nurse Practitioner
  • South Padre Island, TX
  • NPI 1467966374
  NPD (past)
• Michael Dean Johnson, PH.D.

  • Clinical Psychologist
  • Houston, TX
  • NPI 1063585784
  NPD (past)
• Victor A Oderinde, M.D.

  • Psychiatry Physician
  • Spring, TX
  • NPI 1861486482
  NPD (past)
• Javier Ruiz-Nazario, M.D.

  • Psychiatry Physician
  • Spring, TX
  • NPI 1972569721
  NPD (past)
• Cara Westerman, OTR

  • Occupational Therapist
  • Manvel, TX
  • NPI 1528517299
  NPD (past)
• Amarilis Talavera-Briggs, M.D.

  • Psychiatry Physician
  • New London, CT
  • NPI 1952499733
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1992877948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84469",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775840011",
            "telephone_number": "281-489-1290",
            "fax_number": "281-489-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4774 DEL BELLO RD",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "77578",
            "telephone_number": "281-489-1290",
            "fax_number": "281-489-0167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3926 Bahler Ave",
            "address_purpose": "LOCATION",
            "city": "Manvel",
            "state": "TX",
            "postal_code": "775782823",
            "country_code": "US",
            "telephone_number": "281-489-1290",
            "fax_number": "281-489-8806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4242 Old Massey Ranch Rd",
            "address_purpose": "LOCATION",
            "city": "Manvel",
            "state": "TX",
            "postal_code": "775787757",
            "country_code": "US",
            "telephone_number": "281-489-1290",
            "fax_number": "281-489-8806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHILOH TREATMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-489-1290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TX",
            "license": "TDFPS517689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lindsay Shelton, M.ED, LPC
• Idris Shoaga, PA-C
• Melissa Ann Sifuentes
• Gabrielle Darian Silguero
• Debora Joyce Simmons, RN CCNS FAAN
• Haley Sincere

• Psychiatric Residential Treatment Facility in Manvel, TX
• Providers in Manvel, TX by specialty
• Psychiatric Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.