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SHINE SENIOR CENTER NPI 1700261633


NPI Information

NPI: 1700261633
Provider Name: SHINE SENIOR CENTER
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

CLIA Number: 21D2099639

Address:
9198 RED BRANCH RD STE H
COLUMBIA, MD
ZIP 21045
Phone: (301) 310-3067
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SHINE SENIOR CENTER is an adult day care clinic center in Columbia, MD. SHINE SENIOR CENTER NPI is 1700261633. The provider is registered as an organization entity type.

The provider's business location address is:

9198 RED BRANCH RD STE H
COLUMBIA, MD
ZIP 21045-017
Phone: (301) 310-3067
Fax: (410) 772-3933

The provider's authorized official is Seongbok Lee .
The authorized official title is President and has the following contact phone number (301) 821-7214.

The CLIA number assigned to this NPI record is 21D2099639 - other - adult medical day care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/21/2015 and was last updated on 7/21/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA0600XClinic/CenterAdult Day CareTBAMARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.