Provider Demographics
NPI:1194695700
Name:RADIANT SHORE LIVING LLC
Entity type:Organization
Organization Name:RADIANT SHORE LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATCHMANSINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-619-8918
Mailing Address - Street 1:1859 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-2617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1859 PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-2617
Practice Address - Country:US
Practice Address - Phone:973-619-8918
Practice Address - Fax:973-619-8918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-08
Last Update Date:2025-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty