| NPI | 1821151028 |
|---|---|
| Other Name | SHINING STAR CLUBHOUSE |
| Entity Type | Organization |
| Authorized Contact | MILTON TEAGUE Director 910-739-6624 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-08-09 |