Provider Demographics
NPI:1285212340
Name:SUN VALLEY HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:SUN VALLEY HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:GERALDE
Authorized Official - Last Name:MENGUAL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-860-1888
Mailing Address - Street 1:156 W AVENUE A
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-3018
Mailing Address - Country:US
Mailing Address - Phone:561-860-1888
Mailing Address - Fax:
Practice Address - Street 1:156 W AVENUE A
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-3018
Practice Address - Country:US
Practice Address - Phone:561-860-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service