Provider Demographics
NPI:1871273433
Name:SHINE CARE HOME HEALTH INC
Entity type:Organization
Organization Name:SHINE CARE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MANTASHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-807-0087
Mailing Address - Street 1:22048 SHERMAN WAY STE 216
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1841
Mailing Address - Country:US
Mailing Address - Phone:818-807-0087
Mailing Address - Fax:818-484-2959
Practice Address - Street 1:22048 SHERMAN WAY STE 216
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1841
Practice Address - Country:US
Practice Address - Phone:818-807-0087
Practice Address - Fax:818-484-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health