Organization
SHINE PLACE
Active
Organization
SHINE PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LECIA ICARI (OWNER)
(619) 600-6003
Entity
Organization
Contact information
Practice address
336 WINEWOOD ST, SAN DIEGO, CA 92114-5956
(619) 600-6003
Mailing address
336 WINEWOOD ST, SAN DIEGO, CA 92114-5956
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/07/2020
Last updated
04/07/2020
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