Provider Demographics
NPI:1477378743
Name:SUNSHINE SANDS LLC
Entity type:Organization
Organization Name:SUNSHINE SANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGFRIED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-345-7024
Mailing Address - Street 1:5088 GLENWOOD SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-9291
Mailing Address - Country:US
Mailing Address - Phone:916-899-4581
Mailing Address - Fax:
Practice Address - Street 1:5088 GLENWOOD SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-9291
Practice Address - Country:US
Practice Address - Phone:916-899-4581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility