Provider Demographics
NPI:1598433005
Name:SUNSHINE BEHAVIORAL HOME LLC
Entity Type:Organization
Organization Name:SUNSHINE BEHAVIORAL HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANETT
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-565-1812
Mailing Address - Street 1:13614 N 89TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-7653
Mailing Address - Country:US
Mailing Address - Phone:480-572-1850
Mailing Address - Fax:
Practice Address - Street 1:13614 N 89TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7653
Practice Address - Country:US
Practice Address - Phone:480-572-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)