Provider Demographics
NPI:1053644336
Name:THE SUN HOME HEALTH CARE AT MANSFIELD, INC
Entity Type:Organization
Organization Name:THE SUN HOME HEALTH CARE AT MANSFIELD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYSHRI
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-362-5035
Mailing Address - Street 1:166 PARK AVE W.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44902
Mailing Address - Country:US
Mailing Address - Phone:740-272-3371
Mailing Address - Fax:
Practice Address - Street 1:166 PARK AVE W.
Practice Address - Street 2:SUITE 205
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44902
Practice Address - Country:US
Practice Address - Phone:740-272-3371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========Medicaid