Provider Demographics
NPI:1043317571
Name:SHINE N STARS, LLC
Entity type:Organization
Organization Name:SHINE N STARS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-447-2301
Mailing Address - Street 1:525 CHEROKEE TRL
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36206-1021
Mailing Address - Country:US
Mailing Address - Phone:256-820-0560
Mailing Address - Fax:256-820-0560
Practice Address - Street 1:525 CHEROKEE TRL
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36206-1021
Practice Address - Country:US
Practice Address - Phone:256-820-0560
Practice Address - Fax:256-820-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL034786322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children