Organization
SHALOM HOME CARE CORPORATION LLC DBA SHALOM HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILBERT J PACHECO (OWNER/OPERATOR)
(719) 542-2715
Entity
Organization
Contact information
Practice address
134 LAMAR AVE, PUEBLO, CO 81004-1907
(719) 542-2715
(719) 543-6358
Mailing address
134 LAMAR AVE, PUEBLO, CO 81004-1907
(719) 542-2715
(719) 543-6358
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
230659
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32771754
—
CO
Enumeration date
01/18/2016
Last updated
01/18/2016
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