# SH1 CARMEL OPCO LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** The Pines on Carmel Senior Living
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215691464
- **Authorized official:** MS. TERRI BAKER (FINANCE AND LICENSING COORDINATOR)
- **Authorized official phone:** (503) 998-5810

## Contact information

- **Practice address:** 5820 CARMEL RD, CHARLOTTE, NC 28226-8106
- **Practice address phone:** (704) 544-4979
- **Practice address fax:** (704) 540-7883
- **Mailing address:** 5101 NE 82ND AVE STE 200, VANCOUVER, WA 98662-6343
- **Mailing address phone:** (360) 254-9442
- **Mailing address fax:** (360) 254-1770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/25/2021
- **Last updated:** 12/08/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PE-EHE5B2A5K | — | NC |
| 05 | — | TBD | — | NC |