Active NPI
Shine Christian Senior Center
- Adult Day Care Clinic/Center
- Duluth, GA
National Provider Identifier
1942909635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- SHINE CHRISTIAN SENIOR CENTER
- Practice address
- 1795 Buford Hwy
Duluth, GA 30097-2806 - Phone
- (470) 426-1904
- NPI assigned
- Mar 1, 2023
- Organization subpart
- Yes
- Parent organization
- SHINE LIGHT INTERNATIONAL BAPTIST CHURCH, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Esther Haekang Lim, MD
- Title
- Operation Clinical Director
- Phone
- (470) 426-1904
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
1795 Buford Hwy
Duluth, GA 30097-2806
Mailing address
1795 Buford Hwy
Duluth, GA 30097-2806
Phone (470) 426-1904
Other names 1
- Shine Light Church
National Provider Directory
National Provider Directory- Part of
- Shine Christian Senior Center
Locations
1795 Buford Hwy
Duluth, GA 30097
Phone (470) 426-1904
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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- Philadelphia, PA
- NPI 1578579769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677628800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1677628800000",
"number": "1942909635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1795 BUFORD HWY",
"city": "DULUTH",
"state": "GA",
"postal_code": "300972806",
"telephone_number": "470-426-1904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1795 BUFORD HWY",
"city": "DULUTH",
"state": "GA",
"postal_code": "300972806",
"telephone_number": "470-426-1904"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHINE CHRISTIAN SENIOR CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SHINE LIGHT INTERNATIONAL BAPTIST CHURCH, INC",
"enumeration_date": "2023-03-01",
"last_updated": "2023-03-01",
"certification_date": "2023-03-01",
"status": "A",
"authorized_official_last_name": "LIM",
"authorized_official_first_name": "ESTHER",
"authorized_official_middle_name": "HAEKANG",
"authorized_official_title_or_position": "OPERATION CLINICAL DIRECTOR",
"authorized_official_telephone_number": "470-426-1904",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Shine Light Church",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.