Organization
SHINING STAR HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDE FOMENKY (CEO)
(410) 497-4917
Entity
Organization
Contact information
Practice address
16701 MELFORD BLVD STE 400, OFFICE # 452, BOWIE, MD 20715
(410) 497-4917
Mailing address
16701 MELFORD BLVD STE 400, BOWIE, MD 20715-4305
(410) 497-4917
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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