Provider Demographics
NPI:1407685753
Name:SHINING STARS ADULT DAYCARE CORP
Entity type:Organization
Organization Name:SHINING STARS ADULT DAYCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MASUD
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-316-3375
Mailing Address - Street 1:17016 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4547
Mailing Address - Country:US
Mailing Address - Phone:718-316-3375
Mailing Address - Fax:
Practice Address - Street 1:9021 160TH ST FL 2
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6125
Practice Address - Country:US
Practice Address - Phone:718-316-3375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care