Provider Demographics
NPI:1417642166
Name:SUNSHINE HOME SUPPORT SERVICES
Entity Type:Organization
Organization Name:SUNSHINE HOME SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BIKINO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEUMERCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-409-5033
Mailing Address - Street 1:586 WESTBROOK ST UNIT 509
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-1407
Mailing Address - Country:US
Mailing Address - Phone:207-409-5033
Mailing Address - Fax:
Practice Address - Street 1:586 WESTBROOK ST UNIT 509
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-1407
Practice Address - Country:US
Practice Address - Phone:207-409-5033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care