Provider Demographics
NPI:1629026810
Name:SUNSET DEVELOPMENTAL SUPPORT SERVICES,INC
Entity Type:Organization
Organization Name:SUNSET DEVELOPMENTAL SUPPORT SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HAYDEE
Authorized Official - Middle Name:MACHADO
Authorized Official - Last Name:MILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-598-5333
Mailing Address - Street 1:9370 SW 72ND ST
Mailing Address - Street 2:STE # 107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5431
Mailing Address - Country:US
Mailing Address - Phone:305-598-5333
Mailing Address - Fax:305-598-8100
Practice Address - Street 1:9370 SW 72ND ST
Practice Address - Street 2:STE # 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5431
Practice Address - Country:US
Practice Address - Phone:305-598-5333
Practice Address - Fax:305-598-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL679879996251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL679879996Medicaid