1457867376 NPI number — SUNSHINE INC. RESIDENTIAL AND SUPPORT SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457867376 NPI number — SUNSHINE INC. RESIDENTIAL AND SUPPORT SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUNSHINE INC. RESIDENTIAL AND SUPPORT SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457867376
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7223 MAUMEE WESTERN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAUMEE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43537-9755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-794-1371
Provider Business Mailing Address Fax Number:
419-865-5607

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1755 OLIMPHIA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43615-3413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-865-0251
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HENSON
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
419-794-1371

Provider Taxonomy Codes

  • Taxonomy code: 315P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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