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General NPI Number Information
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NPI Number | 1255094942
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Entity Type | Organization
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Legal Business Name | SHINING STAR HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 16244 S MILITARY TRL STE 460
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6532
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Country | US
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Telephone | 561-450-6266
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Fax | 561-819-8749
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Provider Business Mailing Address
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Address Line | 4635 CHERRY LAUREL LN
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City | DELRAY BEACH
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State | FL
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Zip | 33445-7041
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Country | US
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Telephone | 561-789-5623
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Fax | 561-819-8749
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. FERIAL F ANDRE
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Credential | RN, CCM, CDP
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Telephone | 561-450-6266
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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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