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Shining Star
Emotionally Disturbed Childrens' Residential Treatment Facility in Spring Lake, North Carolina
NPI 1134226160

Shining Star is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Fayetteville, NC. Shining Star practices in Spring Lake, NC. The NPI Number for Shining Star is 1134226160 and holds a License No. MHL-043-045 (North Carolina).

The current practice location address for Shining Star is 378 Appaloosa Dr, Spring Lake, NC and can be reached out via phone at 910-904-6699 and via fax at 910-904-1879.

Location: 378 Appaloosa Dr, Spring Lake, NC, 28302-2744
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1134226160
Provider Name
Shining Star
Credential
Provider Entity Type
Organization
Address
378 Appaloosa Dr, Spring Lake, NC, 28302-2744
Phone Number
910-904-6699
Fax Number
910-904-1879
Provider Enumeration Date
09/20/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
6603538 05 NC
institution
Provider Business Practice Location Address Details
Address
378 Appaloosa Dr
City
Spring Lake
State
North Carolina
Zip
28390-8504
Phone Number
910-904-6699
Fax Number
910-904-1879
person
Provider Business Mailing Address Details
Address
378 Appaloosa Dr
City
Spring Lake
State
North Carolina
Zip
28390-8504
Phone Number
910-904-6699
Fax Number
910-904-1879
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
MHL-043-045 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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