Shining Star Community Health Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SHINING STAR COMMUNITY HEALTH SERVICES, LLC

Practice address

3601 Green Hollow Dr
Grand Prairie, TX 75052-6716

Phone

(972) 589-8580

NPI assigned

Sep 20, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Neal E Cross, MBA

Title

Ceo

Phone

(972) 589-8580

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1760966220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 GREEN HOLLOW DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526716",
            "telephone_number": "972-589-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 GREEN HOLLOW DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526716",
            "telephone_number": "972-589-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING STAR COMMUNITY HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-589-8580",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.