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General NPI Number Information
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NPI Number | 1700691052
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Entity Type | Organization
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Legal Business Name | SHINY HOMES LLC
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 1300 WISCONSIN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15216-2555
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Country | US
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Telephone | 234-303-9210
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 WISCONSIN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15216-2555
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Country | US
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Telephone | 234-303-9210
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ELHADJ ALPHA MAHMOUD SOUARE
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Credential |
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Telephone | 234-303-9210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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