Provider Demographics
NPI:1811788813
Name:SUNNYSIDE RESIDENTIAL HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:SUNNYSIDE RESIDENTIAL HOME CARE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-932-0195
Mailing Address - Street 1:1398 SW 160TH AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1988
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1398 SW 160TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1988
Practice Address - Country:US
Practice Address - Phone:954-932-0195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care