Provider Demographics
NPI:1083739023
Name:SUNSHINE CHILDENS HOME, INC
Entity Type:Organization
Organization Name:SUNSHINE CHILDENS HOME, INC
Other - Org Name:SUNSHINE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-358-5722
Mailing Address - Street 1:9215 COUNTY LANE 175
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-8812
Mailing Address - Country:US
Mailing Address - Phone:417-358-5722
Mailing Address - Fax:417-358-9676
Practice Address - Street 1:9215 COUNTY LANE 175
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-8812
Practice Address - Country:US
Practice Address - Phone:417-358-5722
Practice Address - Fax:417-358-9676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1327-9830320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities