Organization
SHINES SUPPORT LTD
Active
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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