| Organization Name: | SHINING STAR CAREGIVERS, LLC |
| NPI Number: | 1033429337 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY CARDIN (OWNER) |
| Mailing Address: | 2512 Pine Ridge Ct Durango |
| State: | CO US |
| Postal Code: | 813015872 |
| Phone Number: | 9709462932 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2010 |
| NPI Last Update Date: | 10/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 15777320000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |