Provider Demographics
NPI:1871071662
Name:SHINING CARE LLC
Entity type:Organization
Organization Name:SHINING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-416-9036
Mailing Address - Street 1:32 FRANCIS ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6124
Mailing Address - Country:US
Mailing Address - Phone:617-416-9036
Mailing Address - Fax:
Practice Address - Street 1:32 FRANCIS ST STE 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6124
Practice Address - Country:US
Practice Address - Phone:617-416-9036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care