Provider Demographics
NPI:1558014795
Name:SUN VALLEY HOME HEALTH & PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SUN VALLEY HOME HEALTH & PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MENGUAL JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-574-3165
Mailing Address - Street 1:156 W AVENUE A
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-3018
Mailing Address - Country:US
Mailing Address - Phone:561-983-8758
Mailing Address - Fax:
Practice Address - Street 1:156 W AVENUE A
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-3018
Practice Address - Country:US
Practice Address - Phone:561-983-8758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health