Provider Demographics
NPI:1205152022
Name:SUNSHINE HEALTH CARE CENTER
Entity type:Organization
Organization Name:SUNSHINE HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC MEDICAL DOCTOR/MEDICAL
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:480-298-4759
Mailing Address - Street 1:13660 N 94TH DR
Mailing Address - Street 2:SUITE C4
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4841
Mailing Address - Country:US
Mailing Address - Phone:623-266-1722
Mailing Address - Fax:623-266-1746
Practice Address - Street 1:13660 N 94TH DR
Practice Address - Street 2:SUITE C4
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4841
Practice Address - Country:US
Practice Address - Phone:623-266-1722
Practice Address - Fax:623-266-1746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15815207Q00000X
AZ15343207Q00000X
AZ081064175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty