Provider Demographics
NPI:1689183261
Name:THE SUNSHINE HOUSE OF HOUSTON
Entity Type:Organization
Organization Name:THE SUNSHINE HOUSE OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:409-771-2484
Mailing Address - Street 1:5305 WILMINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-3256
Mailing Address - Country:US
Mailing Address - Phone:346-240-4623
Mailing Address - Fax:
Practice Address - Street 1:5305 WILMINGTON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-3256
Practice Address - Country:US
Practice Address - Phone:346-240-4623
Practice Address - Fax:346-240-4623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1104343037OtherINDIVIDUAL NPI