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Organization

SHINES SUPPORT LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TASHEANNA MARTIN M.ED (CEO)
(216) 972-4000
Entity
Organization

Contact information

Practice address
6100 OAK TREE BLVD STE 200, INDEPENDENCE, OH 44131-6914
(216) 972-4000
Mailing address
3675 WARRENSVILLE CENTER RD UNIT 201243, SHAKER HEIGHTS, OH 44120-5266
(216) 972-4000

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
332U00000X
Home Delivered Meals
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle

Other

Enumeration date
07/09/2024
Last updated
07/09/2024
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