Shady Shores of Premont LLC
NPI 1881079101 · Skilled Nursing Facility · Premont, TX
Shady Shores of Premont LLC is a Skilled Nursing Facility organization in Premont, TX (NPI 1881079101).
Provider details
- NPI number
- 1881079101
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Wallace, Ceo(214) 422-1622
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Premont Rehab and Nursing Center
Registry dates
- Enumerated
- 2015-07-28
- Last updated
- 2016-06-14
Frequently asked questions
- What is Shady Shores of Premont LLC's NPI number?
- Shady Shores of Premont LLC's National Provider Identifier (NPI) is 1881079101, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shady Shores of Premont LLC?
- Shady Shores of Premont LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Shady Shores of Premont LLC located?
- Shady Shores of Premont LLC's practice location on file with NPPES is 431 Nw 3rd St., Premont, TX 78375.
- What is Shady Shores of Premont LLC's phone number?
- The practice phone number listed in the NPPES registry for Shady Shores of Premont LLC is (361) 348-3553.
- Who is the authorized official for Shady Shores of Premont LLC?
- The authorized official listed on Shady Shores of Premont LLC's NPPES record is Michael Wallace, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shady Shores of Premont LLC's NPI active?
- Yes — Shady Shores of Premont LLC's NPI (1881079101) is active in the NPPES registry as of the last update on 2016-06-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.