| Organization Name: | SOUL SHINE CHILDREN'S TREATMENT SERVICES, INC. |
| NPI Number: | 1982818399 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESHIA ROGERS DEESE (OWNER) |
| Mailing Address: | 218 E 2nd Ave Red Springs |
| State: | NC US |
| Postal Code: | 283771308 |
| Phone Number: | 9105366094 |
| Fax Number: | 9108439728 |
| NPI Enumeration Date: | 05/09/2007 |
| NPI Last Update Date: | 07/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LCAS-21969 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |