Provider Demographics
NPI:1891489506
Name:SUNSHINE THERAPUTIC SERVICES, LLC
Entity Type:Organization
Organization Name:SUNSHINE THERAPUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:252-367-2560
Mailing Address - Street 1:149A EMILY DR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8448
Mailing Address - Country:US
Mailing Address - Phone:252-367-2560
Mailing Address - Fax:
Practice Address - Street 1:400 WATAUGA AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3849
Practice Address - Country:US
Practice Address - Phone:252-367-2560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health