Organization
MARQUITA SHINES
Active
Other names
all season personal care home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARQUITA SHUNTA SHINES (OWNER)
(352) 653-0408
Entity
Organization
Contact information
Practice address
55 HICKORY CIR, CARROLLTON, GA 30116-8692
(678) 601-3504
Mailing address
55 HICKORY CIR, CARROLLTON, GA 30116-8692
(678) 601-3504
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/15/2013
Last updated
03/15/2013
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