Provider Demographics
NPI:1053827279
Name:SUNSHINES HOMEMAKER AND COMPANION SERVICES LLC
Entity Type:Organization
Organization Name:SUNSHINES HOMEMAKER AND COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:561-306-9275
Mailing Address - Street 1:1535 SW HUNNICUT AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-7007
Mailing Address - Country:US
Mailing Address - Phone:561-306-9275
Mailing Address - Fax:
Practice Address - Street 1:1535 SW HUNNICUT AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-7007
Practice Address - Country:US
Practice Address - Phone:561-306-9275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LETICIA KELLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-26
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174200000X, 251E00000X, 253Z00000X, 347C00000X
FL235064372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No174200000XOther Service ProvidersMealsGroup - Single Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No347C00000XTransportation ServicesPrivate Vehicle