Provider Demographics
NPI:1831808260
Name:SUNLIGHT CENTER LLC
Entity type:Organization
Organization Name:SUNLIGHT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADDIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-600-6751
Mailing Address - Street 1:25157 SW 108TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6354
Mailing Address - Country:US
Mailing Address - Phone:305-600-6751
Mailing Address - Fax:
Practice Address - Street 1:25157 SW 108TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-6354
Practice Address - Country:US
Practice Address - Phone:305-600-6751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty