Provider Demographics
NPI:1952775421
Name:SHINE HOME HEALTHCARE LLC.
Entity Type:Organization
Organization Name:SHINE HOME HEALTHCARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAMROTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKEW
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:614-598-3001
Mailing Address - Street 1:2833 BRYN MAWR DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8915
Mailing Address - Country:US
Mailing Address - Phone:614-598-3001
Mailing Address - Fax:614-547-7961
Practice Address - Street 1:4770 INDIANOLA AVE STE 208
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1876
Practice Address - Country:US
Practice Address - Phone:614-547-7944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-21
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health