Organization
SHINE ON GROUP HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHEILA J. KOEPPEN (OWNER)
(830) 237-9692
Entity
Organization
Contact information
Practice address
6162 LITTLE BRANDYWINE CRK, SAN ANTONIO, TX 78233-4618
(830) 237-9692
Mailing address
12107 LAS NUBES ST, SAN ANTONIO, TX 78233-5944
(830) 237-9692
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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