Provider Demographics
NPI:1255750857
Name:SUNSHINE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:SUNSHINE BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-892-4342
Mailing Address - Street 1:1102 S RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-3534
Mailing Address - Country:US
Mailing Address - Phone:509-892-4342
Mailing Address - Fax:509-891-1062
Practice Address - Street 1:1102 S RAYMOND RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-3534
Practice Address - Country:US
Practice Address - Phone:509-892-4342
Practice Address - Fax:509-891-1062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSHINE HEALTH FACILITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA236251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management