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General NPI Number Information
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NPI Number | 1215527031
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Entity Type | Organization
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Legal Business Name | SHINING HEARTS LLC
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 101 N COLORADO ST # 1181
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City | CHANDLER
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State | AZ
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Zip | 85225-5534
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Country | US
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Telephone | 520-414-1669
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Fax |
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Provider Business Mailing Address
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Address Line | 101 N COLORADO ST # 1181
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City | CHANDLER
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State | AZ
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Zip | 85225-5534
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Country | US
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Telephone | 520-414-1669
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Fax |
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Authorized Official
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Title or Position | MANAGING EMPLOYEE/MEMBER
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Name | JANAE ELIGINO O'CONNOR
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Credential |
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Telephone | 520-414-1669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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