Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shady Oaks Rest Home Inc

Organization Assisted Living Facility · NPI 1699036285

Shady Oaks Rest Home Inc is an Assisted Living Facility in Daytona Beach, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1208 Kennedy Rd
Daytona Beach, FL 32117
Phone: (386) 253-6993
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 10293 (FL)
Assisted Living Facility Taxonomy 310400000X · Licence AL10293 (FL)

Record details

NPI number1699036285
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Ham — Manager · (386) 562-0870
NPI enumeratedMay 31, 2012
Last updated in NPPESOctober 27, 2014
Mailing address1208 Kennedy Rd, Daytona Beach, FL 32117

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