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Organization

SHINING STAR COMMUNITY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DIANA WADE (CEO/OWNER)
(702) 882-7827
Entity
Organization

Contact information

Practice address
4580 S EASTERN AVE STE 33, LAS VEGAS, NV 89119-6100
(702) 882-7827
(702) 940-6124
Mailing address
4580 S EASTERN AVE STE 33, LAS VEGAS, NV 89119-6100
(702) 882-7827

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
NV
225400000X
Rehabilitation Practitioner

Other

Enumeration date
07/02/2013
Last updated
09/23/2019
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