Provider Demographics
NPI:1528341575
Name:SHINING STAR HOME THERAPY SERVICES,LLC
Entity type:Organization
Organization Name:SHINING STAR HOME THERAPY SERVICES,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR
Authorized Official - Phone:956-343-3188
Mailing Address - Street 1:6611 MORNING SHADOW LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2319
Mailing Address - Country:US
Mailing Address - Phone:956-343-3188
Mailing Address - Fax:210-468-3445
Practice Address - Street 1:6611 MORNING SHADOW LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2319
Practice Address - Country:US
Practice Address - Phone:956-343-3188
Practice Address - Fax:210-468-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health