Provider Demographics
NPI:1649961244
Name:SUNSHINE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:SUNSHINE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUKINZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-523-6284
Mailing Address - Street 1:17617 N 9TH ST APT 3054
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1947
Mailing Address - Country:US
Mailing Address - Phone:702-523-6284
Mailing Address - Fax:
Practice Address - Street 1:17617 N 9TH ST APT 3054
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-1947
Practice Address - Country:US
Practice Address - Phone:702-523-6284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty