Provider Demographics
NPI:1326713082
Name:SUNSHINE LIVING HOME HEALTH LLC
Entity Type:Organization
Organization Name:SUNSHINE LIVING HOME HEALTH LLC
Other - Org Name:SUNSHINE LIVING HOME HEALTH LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:BRENDA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:817-966-7656
Mailing Address - Street 1:6413 SHASTA TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-4432
Mailing Address - Country:US
Mailing Address - Phone:817-966-7656
Mailing Address - Fax:
Practice Address - Street 1:6413 SHASTA TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-4432
Practice Address - Country:US
Practice Address - Phone:817-966-7656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities