Provider Demographics
NPI:1619070745
Name:SUNSHINE HOME CARE OF MICHIGAN, INC.
Entity Type:Organization
Organization Name:SUNSHINE HOME CARE OF MICHIGAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:V
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-208-0649
Mailing Address - Street 1:30600 TELEGRAPH RD STE 3140
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-5730
Mailing Address - Country:US
Mailing Address - Phone:810-412-4378
Mailing Address - Fax:810-412-4376
Practice Address - Street 1:30600 TELEGRAPH RD STE 3140
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-5730
Practice Address - Country:US
Practice Address - Phone:810-412-4378
Practice Address - Fax:810-412-4376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1619070745Medicaid
MI1619070745Medicaid