Organization
SHINE SENIOR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEONGBOK LEE (PRESIDENT)
(301) 821-7214
Entity
Organization
Contact information
Practice address
9198 RED BRANCH RD STE H, COLUMBIA, MD 21045-2017
(301) 310-3067
(410) 772-3933
Mailing address
9198 RED BRANCH RD STE H, COLUMBIA, MD 21045-2017
(301) 310-3067
(410) 772-3933
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
TBA
MD
Other
Enumeration date
07/21/2015
Last updated
07/21/2015
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