Provider Demographics
NPI:1790543882
Name:SUNSHINEANDLOTSOFGRACE LLC
Entity Type:Organization
Organization Name:SUNSHINEANDLOTSOFGRACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO / CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:CROMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-972-2789
Mailing Address - Street 1:244 FL 436
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32712
Mailing Address - Country:US
Mailing Address - Phone:321-972-2789
Mailing Address - Fax:
Practice Address - Street 1:244 FL 436
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32712
Practice Address - Country:US
Practice Address - Phone:321-972-2789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty