Provider Demographics
NPI:1487489134
Name:SHUMATE MANAGEMENT LLC
Entity type:Organization
Organization Name:SHUMATE MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-235-0968
Mailing Address - Street 1:2900 OLD FOREST RD STE A
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2335
Mailing Address - Country:US
Mailing Address - Phone:434-316-1826
Mailing Address - Fax:
Practice Address - Street 1:2900 OLD FOREST RD STE A
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2335
Practice Address - Country:US
Practice Address - Phone:206-235-0968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty