Provider Demographics
NPI:1619220522
Name:SUNNYBROOK HOME CARE, INC
Entity Type:Organization
Organization Name:SUNNYBROOK HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RNC
Authorized Official - Phone:828-693-5417
Mailing Address - Street 1:306 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-5137
Mailing Address - Country:US
Mailing Address - Phone:828-693-5417
Mailing Address - Fax:828-693-5251
Practice Address - Street 1:306 SPRING ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-5137
Practice Address - Country:US
Practice Address - Phone:828-693-5417
Practice Address - Fax:828-693-5251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1494251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health