Provider Demographics
NPI:1245076967
Name:SUNSHINE ADULT DAY PROGRAM LLC
Entity type:Organization
Organization Name:SUNSHINE ADULT DAY PROGRAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-980-0050
Mailing Address - Street 1:8309 W COCOPAH ST
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-8968
Mailing Address - Country:US
Mailing Address - Phone:916-980-0050
Mailing Address - Fax:
Practice Address - Street 1:8309 W COCOPAH ST
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-8968
Practice Address - Country:US
Practice Address - Phone:916-980-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services