Provider Demographics
NPI:1457808339
Name:SUN LIFE FAMILY HEALTH CENTER
Entity Type:Organization
Organization Name:SUN LIFE FAMILY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-836-3446
Mailing Address - Street 1:865 N ARIZOLA RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6011
Mailing Address - Country:US
Mailing Address - Phone:520-836-3446
Mailing Address - Fax:520-350-7557
Practice Address - Street 1:865 N ARIZOLA RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6011
Practice Address - Country:US
Practice Address - Phone:520-836-3446
Practice Address - Fax:520-350-7557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health