MEDICARE: SUNSHINE HOMECARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	347002329	CA

General Provider Information

NPI Number	:	1295001774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE HOMECARE

Provider Business Mailing Address
First Line	:	6905 LE HAVRE WAY
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621-5407
Country	:	US
Telephone Number	:	916-721-5650
Fax Number	:

Provider Business Practice Location Address
First Line	:	6905 LE HAVRE WAY
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621-5407
Country	:	US
Telephone Number	:	916-721-5650
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ANNA BLUSHTEIN
Credential	:
Telephone Number	:	916-595-5729

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	03/28/2012

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