Provider Demographics
NPI:1639622079
Name:SHINING HOPE CORPORATION
Entity type:Organization
Organization Name:SHINING HOPE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TARGETED CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:I
Authorized Official - Credentials:TCM
Authorized Official - Phone:407-409-9363
Mailing Address - Street 1:3019 MESA VERDE DR APT 3105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4387
Mailing Address - Country:US
Mailing Address - Phone:407-409-9363
Mailing Address - Fax:
Practice Address - Street 1:3019 MESA VERDE DR APT 3105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-4387
Practice Address - Country:US
Practice Address - Phone:407-409-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM453-213-74-834-0251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management