Provider Demographics
NPI:1578134722
Name:SACRED HEARTS OF SUNSHINE LLC
Entity Type:Organization
Organization Name:SACRED HEARTS OF SUNSHINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-284-9914
Mailing Address - Street 1:PO BOX 180193
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32318-0002
Mailing Address - Country:US
Mailing Address - Phone:850-284-9914
Mailing Address - Fax:
Practice Address - Street 1:3657 TYSON GREEN WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32310-4963
Practice Address - Country:US
Practice Address - Phone:850-284-9914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty