Organization
SHINNING STAR SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN MARIE SMITH (OWNER)
(612) 998-8441
Entity
Organization
Contact information
Practice address
3311 53RD AVE N, AOT 202, BROOKLYN CENTER, MN 55429-3458
(612) 998-8441
Mailing address
3311 53RD AVE N, AOT 202, BROOKLYN CENTER, MN 55429-3458
(612) 998-8441
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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