Provider Demographics
NPI:1790347995
Name:SUNSHINE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:SUNSHINE BEHAVIORAL HEALTH LLC
Other - Org Name:MONARCH SHORES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANHOOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-750-2014
Mailing Address - Street 1:30950 RANCHO VIEJO RD STE 225
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1772
Mailing Address - Country:US
Mailing Address - Phone:949-877-6873
Mailing Address - Fax:
Practice Address - Street 1:25542 RHODA DR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4669
Practice Address - Country:US
Practice Address - Phone:949-877-6873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSHINE BEHAVIORAL HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-08
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300311HPOtherCALIFORNIA DHCS