Provider Demographics
NPI:1710752795
Name:SUNNYSIDE PRESBYTERIAN HOME
Entity Type:Organization
Organization Name:SUNNYSIDE PRESBYTERIAN HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LANDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-519-1909
Mailing Address - Street 1:600 UNIVERSITY BLVD STE L
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3763
Mailing Address - Country:US
Mailing Address - Phone:540-568-8367
Mailing Address - Fax:540-568-8248
Practice Address - Street 1:501 OAK AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-4400
Practice Address - Country:US
Practice Address - Phone:540-941-3110
Practice Address - Fax:540-941-3330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNNYSIDE PRESBYTERIAN HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty