Provider Demographics
NPI:1245889609
Name:SUNSHINE MENTAL WELLNESS INC
Entity type:Organization
Organization Name:SUNSHINE MENTAL WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, CRNP, PMHNP-BC
Authorized Official - Phone:256-822-2002
Mailing Address - Street 1:2128 6TH AVE SE STE 501
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6563
Mailing Address - Country:US
Mailing Address - Phone:256-822-2002
Mailing Address - Fax:256-822-2003
Practice Address - Street 1:2128 6TH AVE SE STE 501
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6563
Practice Address - Country:US
Practice Address - Phone:256-345-4492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)