Provider Demographics
NPI:1083371330
Name:P AND G SUNSHINE FOUNDATION
Entity Type:Organization
Organization Name:P AND G SUNSHINE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCAIL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:347-247-6650
Mailing Address - Street 1:3200 RACHELL TERRACE
Mailing Address - Street 2:2
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058
Mailing Address - Country:US
Mailing Address - Phone:347-247-6650
Mailing Address - Fax:
Practice Address - Street 1:3200 RACHELL TERRACE
Practice Address - Street 2:2
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058
Practice Address - Country:US
Practice Address - Phone:347-247-6650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child