Provider Demographics
NPI:1932571569
Name:SUNNYSIDE HEALTH INC
Entity Type:Organization
Organization Name:SUNNYSIDE HEALTH INC
Other - Org Name:BEND HEALING ARTS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINREB
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, LAC
Authorized Official - Phone:541-306-7842
Mailing Address - Street 1:21045 BAYOU DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2437
Mailing Address - Country:US
Mailing Address - Phone:541-306-7842
Mailing Address - Fax:541-322-8928
Practice Address - Street 1:21045 BAYOU DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2437
Practice Address - Country:US
Practice Address - Phone:541-306-7842
Practice Address - Fax:541-322-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00170171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty