Provider Demographics
NPI:1760197065
Name:SUNLIGHT HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SUNLIGHT HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OKARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-470-8417
Mailing Address - Street 1:228 COLUMBINE LN
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-3497
Mailing Address - Country:US
Mailing Address - Phone:612-470-8417
Mailing Address - Fax:
Practice Address - Street 1:228 COLUMBINE LN
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3497
Practice Address - Country:US
Practice Address - Phone:612-470-8417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility