OrganizationMind Shine, LlcCommunity/Behavioral HealthAgenciesPractice Address8360 Six Forks Rd, Raleigh, NC 27615-5077(919) 758-4559PECOS EnrollmentBased on the most recent information from CMS, provider Mind Shine, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1558878082Provider TypeOrganizationFull NameMind Shine, LlcSubpartNoEnumeration Date1/5/2018Last Updated1/5/2018Contact InformationPractice LocationPractice Address8360 Six Forks Rd, Raleigh, NC 27615-5077Phone(919) 758-4559FaxUnlisted FaxMailing LocationMailing Address8360 Six Forks Rd Ste 102, Raleigh, NC 27615-5087Phone(919) 758-4559FaxUnlisted FaxAuthorized OfficialNameSharif-Hanifa, Sabriya Laila (Ceo)Phone(919) 758-4559Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicense3175-ANorth Carolina