Provider Demographics
NPI:1518408079
Name:SUNSHINE TUCSON ACH, LLC
Entity Type:Organization
Organization Name:SUNSHINE TUCSON ACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:RICA
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:PIJUAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-514-9997
Mailing Address - Street 1:5674 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-5914
Mailing Address - Country:US
Mailing Address - Phone:520-514-9997
Mailing Address - Fax:
Practice Address - Street 1:5674 E 25TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-5914
Practice Address - Country:US
Practice Address - Phone:520-514-9997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL10244H311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home