| Full Name | Shine Above Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 60 Holland St, Lewiston, Maine |
| Authorized Official Name and Position | Nicole Moore (OWNER/FINANCIAL MANAGER) |
| Authorized Official Contact | 2077542466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine Above Llc 60 Holland St Lewiston ME 04240-7514 Ph: (207) 754-2466 | Shine Above Llc 60 Holland St Lewiston ME 04240-7514 Ph: (207) 754-2466 |
| NPI Number | 1326775644 |
|---|---|
| Provider Enumeration Date | 08/05/2022 |
| Last Update Date | 08/10/2022 |
| Certification Date | 08/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326775644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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