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Organization
MARQUITA SHINES
Active
Organization
MARQUITA SHINES
Active
Other names
all season personal care home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARQUITA SHUNTA SHINES (OWNER)
(352) 653-0408
Entity
Organization
Contact information
Practice address
55 HICKORY CIR, CARROLLTON, GA 30116-8692
(678) 601-3504
Mailing address
55 HICKORY CIR, CARROLLTON, GA 30116-8692
(678) 601-3504
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
347C00000X
Private Vehicle
—
NULL
Other
Enumeration date
03/15/2013
Last updated
03/15/2013
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