O Shine Residential Home, Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

O SHINE RESIDENTIAL HOME, INC

Practice address

1903 Trailridge Dr
Richardson, TX 75081-4734

Phone

(469) 233-6741

Fax

(214) 594-9266

NPI assigned

Jul 29, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ellen Clinton

Title

Consultant

Phone

(817) 903-7600

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1174296602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 TRAILRIDGE DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750814734",
            "telephone_number": "469-233-6741",
            "fax_number": "214-594-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 TRAILRIDGE DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750814734",
            "telephone_number": "469-233-6741",
            "fax_number": "214-594-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O SHINE RESIDENTIAL HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "CLINTON",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "817-903-7600"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Nwokedi
• Frederick Nyhan, D.C.
• Sarah Elizabeth Nyquist
• Nnamdi Nzeh
• Victor Nzelu
• Hilary O'Connor, DPT
• Emma Mikell O'Neal
• Oakmont Surgical Affiliates
• Eva Obergfell, LPC ASSOCIATE
• Meghan Elise Obrien

• Adult Care Home Facility in Richardson, TX
• Providers in Richardson, TX by specialty
• Adult Care Home Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.