Provider Demographics
NPI:1073674982
Name:SUNSHINE HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:SUNSHINE HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOULBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-347-4074
Mailing Address - Street 1:2325 SW 131ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2662
Mailing Address - Country:US
Mailing Address - Phone:954-347-4074
Mailing Address - Fax:
Practice Address - Street 1:5546 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1401
Practice Address - Country:US
Practice Address - Phone:954-347-4074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health