Healthcare Provider Details

I. General information

NPI: 1134525470
Provider Name (Legal Business Name): WORLDSHINE INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 PROFESSIONAL DR
GAITHERSBURG MD
20879-3418
US

IV. Provider business mailing address

700 PROFESSIONAL DR
GAITHERSBURG MD
20879-3418
US

V. Phone/Fax

Practice location:
  • Phone: 240-899-4898
  • Fax: 240-767-6058
Mailing address:
  • Phone: 240-332-5466
  • Fax: 240-767-6058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number15-004-A
License Number StateMD

VIII. Authorized Official

Name: MR. QILI LI
Title or Position: MANAGING MEMBER
Credential:
Phone: 301-562-1999