Provider Demographics
NPI:1831513803
Name:SUNSHINE THERAPY & HEALTH CENTER, LLC
Entity type:Organization
Organization Name:SUNSHINE THERAPY & HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CAP
Authorized Official - Phone:386-451-6343
Mailing Address - Street 1:114 W NEW YORK AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-5416
Mailing Address - Country:US
Mailing Address - Phone:386-451-6343
Mailing Address - Fax:
Practice Address - Street 1:114 W NEW YORK AVE
Practice Address - Street 2:SUITE C
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-5416
Practice Address - Country:US
Practice Address - Phone:386-451-6343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2619251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008810600Medicaid