Provider Demographics
NPI:1326355694
Name:THE SUNSHINE INN, INC.
Entity Type:Organization
Organization Name:THE SUNSHINE INN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-988-3959
Mailing Address - Street 1:1645 HIGHWAY 178 W
Mailing Address - Street 2:
Mailing Address - City:MYRTLE
Mailing Address - State:MS
Mailing Address - Zip Code:38650-9690
Mailing Address - Country:US
Mailing Address - Phone:662-988-3959
Mailing Address - Fax:662-988-3989
Practice Address - Street 1:1645 HIGHWAY 178 W
Practice Address - Street 2:
Practice Address - City:MYRTLE
Practice Address - State:MS
Practice Address - Zip Code:38650-9690
Practice Address - Country:US
Practice Address - Phone:662-988-3959
Practice Address - Fax:662-988-3989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS918310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility