Provider Demographics
NPI:1003552373
Name:SUNSHINE MINNIE GROUP HOMES CARE LLC
Entity Type:Organization
Organization Name:SUNSHINE MINNIE GROUP HOMES CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANOUCHECA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-234-1590
Mailing Address - Street 1:6630 CORAL COVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-2849
Mailing Address - Country:US
Mailing Address - Phone:754-234-1590
Mailing Address - Fax:
Practice Address - Street 1:6630 CORAL COVE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-2849
Practice Address - Country:US
Practice Address - Phone:754-234-1590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No251E00000XAgenciesHome Health
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty