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Organization
SHINE ADULT CARE LLC
Active
Organization
SHINE ADULT CARE LLC
Active
Other names
Shine Adult Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUETTA RESHON COLEMAN (OWNER/CEO)
(704) 906-2017
Entity
Organization
Contact information
Practice address
10926 DAVID TAYLOR DR STE 102, CHARLOTTE, NC 28262-1042
(980) 217-3340
Mailing address
10926 DAVID TAYLOR DR STE 120, CHARLOTTE, NC 28262-0039
(980) 217-3340
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/12/2024
Last updated
08/14/2024
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