Provider Demographics
NPI:1417633041
Name:SUNSHINE HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:SUNSHINE HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDLE
Authorized Official - Middle Name:BILE
Authorized Official - Last Name:SANWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-223-1328
Mailing Address - Street 1:3226 19TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-7014
Mailing Address - Country:US
Mailing Address - Phone:320-223-1328
Mailing Address - Fax:
Practice Address - Street 1:3226 19TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-7014
Practice Address - Country:US
Practice Address - Phone:320-223-1328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health