Provider Demographics
NPI:1043080229
Name:YOU SHINE TOO
Entity Type:Organization
Organization Name:YOU SHINE TOO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAHREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-787-1295
Mailing Address - Street 1:215 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4737
Mailing Address - Country:US
Mailing Address - Phone:701-787-1295
Mailing Address - Fax:
Practice Address - Street 1:215 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4737
Practice Address - Country:US
Practice Address - Phone:701-787-1295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOU SHINE GUARDIANSHIP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-08
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health