Provider Demographics
NPI:1578232666
Name:CLEAN N SHINE LLC
Entity Type:Organization
Organization Name:CLEAN N SHINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-551-6155
Mailing Address - Street 1:932 SAINT CLAIR WAY STE 6
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3547
Mailing Address - Country:US
Mailing Address - Phone:724-691-0413
Mailing Address - Fax:
Practice Address - Street 1:932 SAINT CLAIR WAY STE 6
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3547
Practice Address - Country:US
Practice Address - Phone:724-691-0413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care