Shine Treatment Center LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SHINE TREATMENT CENTER LLC

Practice address

3295 E Rebel LN
San Tan Valley, AZ 85143-1705

Phone

(208) 505-7176

NPI assigned

Sep 13, 2024

Organization subpart

No

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

Authorized official

Name

David Lawlor

Title

Chairman

Phone

(208) 505-7176

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726876800000",
    "number": "1497581508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3295 E REBEL LN",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851431705",
            "telephone_number": "208-505-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 E REBEL LN",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851431705",
            "telephone_number": "208-505-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A",
        "authorized_official_last_name": "LAWLOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "208-505-7176"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey Paul Shiflet, D.C.
• Eric L Shifley, PT
• Bryton Shinkle, LAC
• Taylor Shockley, PT, DPT
• Leann Silva
• Mark Simmons
• Abhilasha Singh, MD

• Behavior Analyst in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2024; 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.