Provider Demographics
NPI:1700567419
Name:SHINING HOME HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:SHINING HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-224-7660
Mailing Address - Street 1:2707 S 260TH LN APT J206
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-8952
Mailing Address - Country:US
Mailing Address - Phone:206-778-1082
Mailing Address - Fax:206-687-9723
Practice Address - Street 1:2707 S 260TH LN APT J206
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-8952
Practice Address - Country:US
Practice Address - Phone:206-778-1082
Practice Address - Fax:206-687-9723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health