Provider Demographics
NPI:1407633068
Name:SUNLIGHT HOME CARE LLC
Entity Type:Organization
Organization Name:SUNLIGHT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MR
Authorized Official - Prefix:
Authorized Official - First Name:ABDISHAKUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMAD ABDULAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-446-8844
Mailing Address - Street 1:268 TALL GRASS TRL
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-4639
Mailing Address - Country:US
Mailing Address - Phone:614-446-8844
Mailing Address - Fax:
Practice Address - Street 1:268 TALL GRASS TRL
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-4639
Practice Address - Country:US
Practice Address - Phone:614-446-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care