Provider Demographics
NPI:1649585712
Name:SUNSHINE IN HOME PRIVATE DUTY SERVICES, INC.
Entity Type:Organization
Organization Name:SUNSHINE IN HOME PRIVATE DUTY SERVICES, INC.
Other - Org Name:SUNSHINE PRIVATE DUTY SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:VAUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-412-4378
Mailing Address - Street 1:1040 S STATE RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-1904
Mailing Address - Country:US
Mailing Address - Phone:810-412-4378
Mailing Address - Fax:810-412-4376
Practice Address - Street 1:1040 S STATE RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1904
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:2010-08-13
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care