Provider Demographics
NPI:1992214290
Name:SUNSHINE HOMECARE SUPPORT SERVICES CORP.
Entity Type:Organization
Organization Name:SUNSHINE HOMECARE SUPPORT SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-726-2814
Mailing Address - Street 1:2539 S HOLLAND CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2939
Mailing Address - Country:US
Mailing Address - Phone:303-989-2566
Mailing Address - Fax:720-292-1883
Practice Address - Street 1:2539 S HOLLAND CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2939
Practice Address - Country:US
Practice Address - Phone:303-989-2566
Practice Address - Fax:720-292-1883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
CO04V346253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care