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Organization

SHINING STAR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. STEPHANIE WATT (CEO)
(313) 377-1849
Entity
Organization

Contact information

Practice address
1325 CADILLAC BLVD, DETROIT, MI 48214-3105
(313) 377-1849
(313) 557-2751
Mailing address
PO BOX 15122, DETROIT, MI 48215-0122
(313) 377-1849
(313) 557-2751

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
02/14/2011
Last updated
06/03/2016
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