# SHINELIGHT, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SHINELIGHT, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417370545
- **Legal business name:** SHINELIGHT, INC.
- **Authorized official:** MS. NIKKI GIOVANNI CREECY (CEO)
- **Authorized official phone:** (910) 257-6406

## Contact information

- **Practice address:** 203 ROWAN ST, FAYETTEVILLE, NC 28301-4921
- **Practice address phone:** (910) 257-6406
- **Mailing address:** 203 ROWAN ST, FAYETTEVILLE, NC 28301-4921
- **Mailing address phone:** (910) 257-6406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/24/2014
- **Last updated:** 04/21/2021