MEDICARE: SUNSHINE COMMUNITY CARE CENTER LLC

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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1760229504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE COMMUNITY CARE CENTER LLC

Provider Business Mailing Address
First Line	:	2705 N CARRIAGE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-0957
Country	:	US
Telephone Number	:	559-478-3736
Fax Number	:	559-520-4819

Provider Business Practice Location Address
First Line	:	5108 E CLINTON WAY
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-2043
Country	:	US
Telephone Number	:	559-375-1058
Fax Number	:	559-520-4819

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PA VUE
Credential	:	RN
Telephone Number	:	559-478-3736

Provider Enumeration Date	:	07/10/2024
Last Update Date	:	01/08/2025

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