Organization
SHALOM ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDY BYRON JR. (DIRECTOR)
(623) 920-1737
Entity
Organization
Contact information
Practice address
3768 BEAR DR, LAKE HAVASU CITY, AZ 86406-4377
(928) 302-1671
Mailing address
18473 W IVY LN, SURPRISE, AZ 85388-2349
(623) 920-1737
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/20/2026
Last updated
03/20/2026
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