Provider Demographics
NPI:1831336163
Name:SUNSHINE AGENCY, LLC
Entity type:Organization
Organization Name:SUNSHINE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:COCO
Authorized Official - Last Name:NDIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-549-2954
Mailing Address - Street 1:4201 SNOWBIRD DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4402
Mailing Address - Country:US
Mailing Address - Phone:361-549-2954
Mailing Address - Fax:361-850-7975
Practice Address - Street 1:4201 SNOWBIRD DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-4402
Practice Address - Country:US
Practice Address - Phone:361-549-2954
Practice Address - Fax:361-850-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty