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General NPI Number Information
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NPI Number | 1710464789
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Entity Type | Organization
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Legal Business Name | SHINING FAMILIES MINISTRY, INC
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 487 WINDCHIME PL STE 300
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1933
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Country | US
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Telephone | 719-659-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 5710 TOMAH DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1933
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Country | US
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Telephone | 719-659-6220
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CHRISTINA CHISMAR
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Credential | LMSW
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Telephone | 719-659-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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