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General NPI Number Information
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NPI Number | 1639622079
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Entity Type | Organization
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Legal Business Name | SHINING HOPE CORPORATION
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 3019 MESA VERDE DR APT 3105
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City | ORLANDO
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State | FL
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Zip | 32837-4387
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Country | US
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Telephone | 407-409-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 3019 MESA VERDE DR APT 3105
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City | ORLANDO
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State | FL
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Zip | 32837-4387
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Country | US
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Telephone | 407-409-9363
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Fax |
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Authorized Official
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Title or Position | TARGETED CASE MANAGER
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Name | MRS. EVA MARIA MELENDEZ I
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Credential | TCM
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Telephone | 407-409-9363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | M453-213-74-834-0
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License Number State | FL
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